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You say sin, I say disease

Are you healthy?

There's an interesting op-ed in New Scientist this week. A psychiatrist and a political scientist make the point that "health" is a loaded term; while in principle we all want to be healthy, it's a word that has been co-opted by those with agendas to push:

Health now means more than the absence of disease or presence of a positive state of bodily flourishing. In 2010, health also describes an ideological and commercial tool, used to make moral judgements, convey prejudice, sell products, or even to exclude groups of people from healthcare.
It's an interesting point — "health" is so self-evidently something that we all care about that if you have an agenda (be it making money by pushing pills, or getting funding for a stadium for your favourite sports team) you can sanctify it simply by pitching it as being all about promoting good health.

It's not hugely controversial to propose that unscrupulous individuals use push-button marketing to make their profit-making schemes seem saintly; there's a lot of greenwashing going on these days, and a lot of money in alternative medicine[1]. But is it possible that imbuing the concept of health with moral value is actively damaging?


In case you've just returned from a decade down a mine shaft, we currently appear to be in the middle of a global epidemic of obesity. It's hard to open a newspaper without reading about frantic attempts to deal with the problem, or to convince people that the problem exists. And we're surrounded by exhortations to eat less and exercise more, couched in the language of sin: gluttony and sloth are the only options on the menu.

However ...

According to Nature news (the RSS news feed of the journal Nature), animals in human care are also fatter today than they were 20 years ago. It's not just people who are packing on the pounds: our pets are also gaining weight. And before you write it off as fat folks feeding Fido far too much, the effect extends to all animals living in proximity to humans, including feral rodents and laboratory animals.

It's easy to see kids crashing out on the sofa and eating too many burgers as receiving their just deserts for not living a virtuous, abstemious, physically gruelling lifestyle — but it may be deeply misguided and an example of our expectations of health being infected by misplaced moralizing. The "gluttony and sloth" model for the obesity epidemic can explain pets being over-fed by their overweight owners, but the further away from the sinners we get, the more tatty the picture: urban rats? Laboratory primates? (Lab animals are not generally over-indulged by their owners.)

There are alternate models for the obesity epidemic. Environmental contamination by endocrine disrupting chemicals might be one direction to look in. Another might be the AD36 adenovirus:

Nikhil Dhurandhar, an obesity researcher at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, has shown that a human adenovirus called AD36 raises body-fat levels in animal models such as chickens and rodents. What's more, he found that obese humans were three times more likely to be infected with the virus than non-obese people -- and heavier individuals in both groups tended to be infected. Dhurandhar reported these findings in a 2005 paper.
The link between AD36 and obesity is suggestive but not yet conclusive, and there are criticisms of the research; it treads on dangerous ground. In particular, many large corporations would love to see the obesity epidemic pinned on something other than their own sub-standard food products (just as coal mines would like to blame climate change on solar output fluctuations).


But the news currently paints a very interesting picture — and one that backs up that New Scientist op-ed about the ideological rhetoric surrounding our definition of health. If AD36 is responsible for the obesity epidemic, then we're not going to cure ourselves[2] through exercise and crash diets: we're going to need vaccine research and epidemiologists instead. But as long as we view obesity as a symptom of moral failure rather than a disease, we're not going to get research into effective treatments.

There is an urgent need for more research. Someone needs to start routinely sampling lab animals, pets, and feral rodents for AD36, and establish whether there is indeed a correlation between AD36 levels and the prevalence of obesity. A next step would be to isolate AD36, infect seronegative lab animals, and see if it induces obesity. If such a link is confirmed, we then need research to establish the underlying mechanism — in fact, it would be the start of the job, not the end.

Edit: Let me clarify: some of the work has already been done. In case you're wondering how an Adenovirus could make us fat, here's the abstract of a paper on that topic (Stem Cells. 2008 Apr;26(4):969-78. Epub 2008 Jan 17):

Abstract: Human adenovirus Ad-36 is causatively and correlatively linked with animal and human obesity, respectively. Ad-36 enhances differentiation of rodent preadipocytes, but its effect on adipogenesis in humans is unknown. To indirectly assess the role of Ad-36-induced adipogenesis in human obesity, the effect of the virus on commitment, differentiation, and lipid accumulation was investigated in vitro in primary human adipose-derived stem/stromal cells (hASC). Ad-36 infected hASC in a time- and dose-dependent manner. Even in the presence of osteogenic media, Ad-36-infected hASC showed significantly greater lipid accumulation, suggestive of their commitment to the adipocyte lineage. Even in the absence of adipogenic inducers, Ad-36 significantly increased hASC differentiation, as indicated by a time-dependent expression of genes within the adipogenic cascade-CCAAT/Enhancer binding protein-beta, peroxisome proliferator-activated receptor-gamma, and fatty acid-binding protein-and consequentially increased lipid accumulation in a time- and viral dose-dependent manner. Induction of hASC to the adipocyte state by Ad-36 was further supported by increased expression of lipoprotein lipase and the accumulation of its extracellular fraction. hASC from subjects harboring Ad-36 DNA in their adipose tissue due to natural infection had significantly greater ability to differentiate compared with Ad-36 DNA-negative counterparts, which offers a proof of concept. Thus, Ad-36 has the potential to induce adipogenesis in hASC, which may contribute to adiposity induced by the virus.

Let's not forget that the AD36 epidemic hypothesis could fall at any of these hurdles. AD36 might just be a random interloper, a suspect fingered by a statistical fluke (a false positive, in other words), and promoted by researches on the payroll of the junk food industry. However, it would be unpleasantly ironic if it turns out that our culture's moralizing fixation on the association between obesity and sinfullness — painting it as the just the reward of sloth and gluttony, and only legitimately to be avoided by drudgery and self-denial — has allowed a dangerous viral pandemic to rage undetected for decades.

But it wouldn't be the first time that moral prejudices based in traditionalist religious views have encouraged the spread of a lethal infectious agent.[3]

*


[1] I'm not taking aim at herbalism here — many of our most effective pharmaceuticals are based on drugs of botanic origin, and not all herbal remedies that are shown to work have been commercialised as allopathic pharmaceuticals. However, I have a problem with homeopathy or biofield therapy; both of these are based on models that just plain don't work — they don't match what we know of biology and chemistry these days (although their internal models were still plausible in the 19th century).

[2] I'm overweight, and not terribly happy about it. I know when it happened, too: in October 1990 to March 1991 my body weight shot up by about 15%, and I've been unable to shed it since. My weight is annoyingly stable (regardless of dietary changes and exercise), and I'd love to pin the blame on a virus; that'd open up new possibilities for fixing it.

[3] Let's not underestimate the lethality of the obesity epidemic. Obese people are more likely to suffer from diabetes, cardiovascular disease, and joint damage. These are all contributors to premature morbidity and mortality. In fact, the total years of life lost to premature mortality among 2-3 billion victims of an obesity virus would be similar to the years of life lost due to diseases such as AIDS or malaria (which are significantly more immediately lethal, but infect a smaller pool).

221 Comments

1:

the effect extends to all animals living in proximity to humans, including feral rodents and laboratory animals.

Would it not be simpler to say that more food is available around humans then before and that we are vastly wasteful of it.

The lab rodents are not as active and don't have the same environmental stresses (predators, competition for food and mates etc...) as feral verities, which could lead to obesity.

I wonder if tests can be devised to measure the relative obesity Vs availability of plentiful human food.

2:

Eat sensibly and get a moderate amount of both anaerobic and aerobic exercise. This alone is enormously difficult. It's what I do. It takes a huge effort, and doesn't seem to be habit forming, in the sense that I hate every minute of the exercise, and am vaguely hungry most of the time. It also (for me) requires ignoring marketing messages of all kinds, including ones "for my health". I've tried some of them. They didn't work. On the other hand, if I don't do these things, I get fat, my knees hurt, and there are various other symptoms that don't bear airing in public. So at least I have motivation.

I think the marketing thing is guilt-driven: most people I know just can't do the eat-sensibly and exercise thing (with which I am totally sympathetic: it sucks), aren't very healthy, and are vulnerable to guilt messages from the media, to the point where they perversely adopt the opposite "embrace your body image" message and are even less inclined to eat sensibly or exercise, or are inclined to magical thinking ("these health bars will cure me").

Through huge effort, I am barely not-quite-overweight.

(Note: part of the reward, freely admitted, is that I am able to drink what I consider to be Too Much Beer; arguably not very healthy, but Quite Enjoyable).

3:

Obese people are more likely to suffer from diabetes, cardiovascular disease, and joint damage.

Traditionally, yes, but IIRC not all obese people have any of the metabolic issues that lead to diabetes and heart problems. Is there any indication that these apply to AD36-or-whatever-it-is-induced obesety vs. traditional obsesty?

4:

While you're probably right in that "we're not going to cure ourselves [of the obesity epidemic] through exercise and crash diets", I'd like to point out that it is necessarily possible to cure oneself of obesity with said exercise and improved diet, AD36 or no:

weight change = (calories in - energy burnt) / calories per kg

Simple law of physics. Of course, I am not saying we shouldn't want to research AD36 -- maybe it makes it harder to burn energy, or has other ill effects unrelated to weight change. I was just worried some people may get the wrong idea that it maybe impossible, rather than perhaps very hard, to lose weight through diet and exercise.

5:

People commonly debate whether social and mental conditions are real diseases. This masquerades as a medical question, but its implications are mainly social and ethical. We use the concept of disease to decide who gets sympathy, who gets blame, and who gets treatment.

Instead of continuing the fruitless "disease" argument, we should address these questions directly. Taking a determinist consequentialist position allows us to do so more effectively. We should blame and stigmatize people for conditions where blame and stigma are the most useful methods for curing or preventing the condition, and we should allow patients to seek treatment whenever it is available and effective.

Diseased thinking: dissolving questions about disease

Link: http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/

6:

Yay biology! Sure, I've got an extra loaf in the bread-basket, but I'm still pretty slim. I eat what I want, and the only exercise I get is the fact that my feet are my main mode of transportation. I walk everywhere (but still only get a mile or two a day).

Oh, and when I work from home, I do it standing at the counter with my laptop all day, instead of in a chair.

But enough about how incredibly fortunate I am. I was heftier in the past, and the big change I made was cutting out processed foods. As a result, I'm eating better- not just healthier, but richer and more enjoyable foods. I dropped about ten pounds with that change.

Which brings us to one of the culprits of the so-called "obesity epidemic": "nutrionism". There is a belief that food is made up of nutrients, and the human body, factor like, takes these inputs and produces outputs- skin, bones, teeth, energy, etc. Hence, it doesn't matter what you're eating, so long as the nutrient counts add up the right way, you have a healthy diet.

This is false, but it's informed a great deal of how we eat. The result is that we eat these pre-digested food-blobs which contain all the nutrients we need, are flavored and tarted up to be palatable, but have about as much resemblance to real food as whiskey to gasoline.

I wouldn't say that it is the only culprit, however. The human body's response to food is very complicated and non-linear (and varies broadly from person to person), and as a result, any attempt to pin a general trend to a single cause is doomed to failure.

Another culprit? Food is fantastically cheap in the western world. You might not be able to rent an apartment working minimum wage, but you can eat as much food as you can stomach on that income.

Our lifestyles have changed from physically laborious to much more chair-piloting. Our daily activities have become much more car focused. Activities have gotten more centralized- we shop at malls and supermarkets, meaning that one trip covers a large variety of needs. We all work in offices, these days.

And so on. There are a lot of factors. A virus could easily be one of them.

7:
AD36 might just be a random interloper, a suspect fingered by a statistical fluke (a false positive, in other words)
Or it might be a symptom, i.e. overweight/obese individuals might be more susceptible to this particular virus (for whatever reason).

Always remember that correlation (A and B appears together) isn't causation (A causes B). Granted, this particular virus seems to cause fat accumulation, but it might be something else at root.

8:

Oh, and in the context of TFA: I actually managed to lose significant weight through diet and exercise, so maybe I wasn't fat because of "teh virus". The point I was probably failing to make is that it was _much_ harder than I expected. I had to essentially wipe myself out four times a week with exercise and feel almost like I was starving much of the time, just to get a little bit of traction, then keep that up for months. It's now been three years, and only within the last few months does it feel like I'm not wiping myself out with my workout, although I still feel quite hungry about half the time.

Much of this was motivated by fear of having to go on high blood pressure medicine for the rest of my life. BP and blood chemistry are now at the high end of optimal rather than the low end of pathalogical.

From what I've heard from others who've tried diet and exercise, they didn't go nearly as far as I did. A little bit here and a little bit there just isn't noticable. Granted, this sounds like bragging, but it is factual, and I am somewhat proud of myself. However, I'm not sure I could recommend it, as I tend to be more obsessive than most people I know, and more willing to suffer somewhat for what I decide is worthwhile.

9:

I've noticed that it doesn't matter even if there _is_ a known causative agent to fat; it's still sinful. And persuading doctors that there might be a causative agent involved is rather difficult at times, even if there is a known family history of say, low thyroid, or a fibroid causing belly swelling; anyone who insists on getting such things checked is Simply Not Facing Up To Their Own Responsibility (once the diagnosis is known, and treatment resolved, the doctor involved often has a massive memory failure regarding previous statements). It's also reasonably well known that post-menopausal women have their metabolisms change on them; but it's Still Their Fault, somehow.

10:

A virus you say? It is quite a strange virus then, which decides it much prefers to live in the U.S., most of the time, than in Europe.

The visual difference between groups of people in the US and groups of people in Europe is staggering. Not only is the number of overweight individuals greater but their amount of personal flab is greater too.

11:

I seem to recall stumbling on life expectancy tables that appeared to suggest that people who were (by the medical definition) overweight (using the BMI cut-off of 25) actually appear to live longer than those in the 'healthy' weight range of 20-25, and that even those at the low end of obese did not seem to have significantly worse life expectancy than those of normal weight. Something I have to confess pleased my inner contrarian, even though as someone who is very nearly underweight, its not good news personally.

It does make me wonder whether we are treating something as a medical problem unnecessarily, possibly because of moral assumptions of fat=lazy=morally wrong=unhealthy. While there may be medical risks associated with overweight, it might be that there are also medical benefits (the obvious one would be the ability to survive periods of illness in which one can't hold down food for longer - something which might well have helped my grandmothers live into their 90s) which we have missed because nobody is looking for them.

That said, its still pretty clear that being morbidly obese is no more good for you than smoking.

12:

**YAWN**

If you look at linguistics: healthy and holy come from the same linguistic roots. So do sanity, sanctity, and sanitation. Sin is literally the state of being without holiness and santitation (or did I mean sanity and sanctity?), so it is appropriate here.

Bottom line: There's nothing new about equating health and sanctity, and I think, if you look at the shamanic roots of religion, that one could argue that all religious activity arose from activities designed to keep people health and well-fed. Miracles still have to do mostly with unexpected health cures, too.

As for the virus: Ummm, can we put on our ecology hats? Just for a second?

What has all changed:
--We've got surpluses of calorie dense, nutrient deficient foods.
--We've got a plethora of new viruses, bacteria, etc. rushing around in this brand new habitat of our globally shared food chain.
--We've got a shift in work from manual labor to manipulating energy from external sources.

Which one caused it the epidemic? Perhaps cause isn't the right word in a system with as many loopy feed backs as our civilization. The good and bad point is that there are many potential levers.

Personally, I'd suggest swallowing a tapeworm of the proper species. That might solve some health issues, and it was present with historical human gut ecosystems.

13:

This makes it sound a lot easier than it is. There's a huge amount of inertia in the process of weight loss. Your body attempts to maintain your body weight, and it will fight very hard to keep you from shedding pounds. So it may do things like drop the energy burnt if you start trying to cut back on the calorie input.

People also don't function in terms of calorie input and calories burnt. They function in terms of eating (which is a very complex process) and activity (ditto). Then there's the additional complex process of storing unburnt calories in the body. And extracting those unburnt calories and using them is a different process than extracting calories from food and using them.

This shouldn't surprise anyone. There are a lot of people trying hard to drop pounds (or kilos!) --- if it was simple there would be a lot more shed. The studies of effectiveness of weight loss programs all show pretty discouraging results. I don't know that there's anything real effective other than stomach-stapling.

Saying it's just calorie input and output is sorta like saying: here are Newton's laws, now go build a car. And biological systems are even more complex than mechanics...

14:

Meh. I'm just glad that we're arguing this semantic issue over obesity these days, as opposed to, oh, homosexuality or anticommunism.

15:

The link with lab animals is also an interesting observation. If the observation that the obesity epidemic is also impacting lab animals that would certainly make experimentation a lot simpler.

My single observation on trying to control my weight was that he closer I get to eating a diet mostly consisting of fresh fruits and vegetables the easier it is to lose weight.

However I've noticed that its really inconvenient to do that because those foods spoil so quickly.

For my cat the vet told me that I should feed her wet food to help her lose weight, its just that the dried kibble is much nicer to handle -- it doesn't smell bad after a day, and it lasts for a few months.

On the other hand one anecdote is pretty useless at teasing apart the various factors.

16:

Well, looking at it from another angle, I'm an atheist so I don't have a problem with redefining "sin" in somewhat more objective terms.

17:

How interesting that the comment thread is already full of people telling you that no matter what, with a little more willpower and determination, you could lose weight.

I get this from people, too, who are trying to be helpful and tell me how to lose weight. (Actually, I've had people give me the same grief about asthma, the flu, and a sprained shoulder. Health being a gift from God, I guess, the lack of it is a sign of being out of grace.) However, it is not always possible to eat less. I eat 900 calories a day and exercise for 5 hours per week in order to maintain my weight at about 20 kilos above what it should be (I've done this for 5 years under a doctor's supervision; my weight stabilized within a month of starting the ultra-low-calorie diet, but has not gone down at all). I already have to take a multivitamin because I can't get enough nutrition from the limited diet I live on. (I already don't eat processed food; my diet is 90 percent local and organic.)

It is not always a simple equation; there's a huge unknown in there, which is calories burned. We make certain assumptions about the body's calorie consumption, but clearly some of us are capable of burning incredibly few calories, perhaps even adjusting the calories burned more selectively than simplistic formulae assume. Some people just seem to extract more from the food they eat than others.

There's plenty of evidence that people have a set-point weight: a weight to which they return over and over again. I've tried some of the dietary tricks that are supposed to change your set-point, but they don't work for me. Which kind of makes sense, given that starving myself doesn't seem to work, either.

Would a virus make sense as an explanation for my condition? I don't know enough about virus behaviour in the body to be sure. I do know that every doctor I have seen about this is convinced it is one of two things: 1. unconscious binge eating (there's no evidence of this) 2. Some unknown medical condition (not very helpful).

A virus centered on Milwaukee or Chicago would actually make sense to me; not all Americans are hugely fat, and they are fat in a particular distribution around that area as a spreading wave (cough). And the fatness is spreading; I was surprised at how large people are getting in Europe on my recent stopover there; the planeful of people from San Francisco were easily the skinniest people in the Frankfurt airport, even with me aboard. It can't be about just the food, because people are getting fat even in places where they don't have GMO soy or corn syrup in practically every food item available.

18:

Perhaps AD36 preferentially infects people who are going to die soon, using the same retrocausal channels that allow psychology experiments to work backwards in time,

19:

Does it actually matter if its gluttony or viral? I live in a house with central heating, regularly travel further in an afternoon than my great-to-n grandparents could travel in a week, have infections cured with antibiotics and talk to the people on the other side of the world daily. Why do we suddenly get upset when someone tries to control one more little part of their life with one more little bit of technology?

20:

Mr. Stross,

Rather than epidemiology, perhaps you might examine paleoanthropology and evolutionary biology for the answers to weight gain, loss and maintenance.

The further we deviate from the metabolic conditions under which we evolved, the more problems we encounter, among them overweight and obesity.

In practical terms, eat meat, fruit, vegetables, nuts and seeds.

As far as the energy balance conception of bodyweight maintenance, Americans are very invested in the ideas of personal agency as well as that old Puritan work ethic. Rigid ideas of personal culpability and gluttony have become entwined with 'calorie in = calorie out' ideology.

As far as a nutritional description of the energy balance equation, physicist Robert McLeod has written:

"Human beings are:
Not in thermal equilibrium with their environment. Last time I checked I have a body temperature around 38 °C and spend most of my time in 21 °C rooms.
Capable of significant mass flows (e.g. respiration).
Capable of sequestering entropy (e.g. protein synthesis).

...

Applying the 1st Law to living organisms is Proof by Tautology. Yes, 1 + 1 = 2, but this tells us absolutely nothing about the underlying mechanics. The 1st Law does not (I repeat N-O-T) tell us whether you store excess energy in the form of fat, or bleed it off into the atmosphere by dilating blood vessels next to the skin, sweating, etc. To do so would require an accounting of entropy."

best,
jason

21:

homeopathy may be based on models that we now know don't work, however, homeopathy can still be quite effective. it's probably just the placebo effect, but the placebo effect is quite powerful--more so than many popular pharmaceuticals.

22:

So, the algorithm is thus: eat sensibly and get moderate exercise, and whatever your resultant weight is, that is not sinful. All else is sin. Plus or minus some slop, of course.

23:

Can you provide any reference to this claim that placebos are more effective than "many popular pharmaceuticals"? Homeopathy is WATER. The placebo effect may put you in a good mindset but it wont cure anything that wouldnt have gone away by itself (whose clearup is consequently attributed to the water sold at £10 a bottle)

24:

This one is Greg Egan being prescient again:

"What's the most patronizing thing you can offer to do for people you disagree with, or don't understand?" "I don't know. What?" "Heal them." --Distress, p. 69 (U.S. paperback edition)

We're past the grossest physical health issues here, obviously; but me, I've been a type A sorta person since before I can recall. Does this mean that if there is a biological basis for this that I must be "unhealthy"? What about people who are thrill-seekers, or their polar opposites? Assuming that there is an easily-assayed biological marker associated with this trait, does this mean that either or both of these types are "unhealthy"?

I suspect that this is a very good 21st-century type question.

25:

Not probably the placebo effect - it is the placebo effect. Last time I read anything about it, thats what was happening, they've studied it and everything, so we know its the placebo effect, no matter how much homeopaths try and pretend it isn't. Its also the "Apply methodology to self limiting and short term symptoms so that they go away of their own accord and we can say it was us" method.

26:

I'm fat, obese in fact, and in recent years have got somewhat fatter: not a good thing for a 40-something male with a congenital high chloresterol level and consequent family history of heart disease and diabetes.

I've recently started to follow a calorie controlled diet, and blow me, it works. I've lost an average of a pound and a half a week and so have shed a over a stone since I've started. You have to be really strict about it; you need to track carefully what you eat during the day, know what your target calorie count is and don't go over it (there is, of course, an app for this, several in fact). I'm not trying to avoid or change the foods I've always eaten, just making sure I don't eat too much. Almost immediately I noticed some heslth improvements - I just don't get the indigestion I used to and I'm sleeping better too.

What us interesting to me, is that the goalposts keep moving. My target weight will give me a BMI of 27.5, a huge improvement on the over 36 I was on. 27.5 will still leave me in the "overweight" category, yet not so many years ago it would have been on the top end of "normal.". Interedtingly, recent research suggests those in th e "overweight." band gave a better life expetency than those in "normal",

27:

Worst thing about the obesity epidemic?

I can't find clothes that fit me. I have a BMI of 20 and something like buying a pair of pants is just about impossible in anything resembling a mainstream store.

(Ever noticed that "Medium" is usually the smallest size on offer? The actual average tends towards L and XL ... sure enough, I need Small sizes and even those tend to be on the wide side.)

Dunno how I do it or why everybody seems to be having problems. The only thing that I know is that I stop eating when the hunger stops, not when I can't possibly shove the least little bit into me (-> being "full"). I always hated it when my parents told me to eat just a little more when I wasn't hungry.

And I just can't shove any large quantities of MSG-laced food into me for any long amount of time. A meal or two is ok, but after that something clicks and tells me that it is disgusting. It seems like my body takes offence with food that doesn't to provide the kind nutrition its taste is advertising. Same for artificial sweeteners. I don't want sweetness. I want sugar. Fat reduced milk? Forget it. I need the real thing.

Dunno if it's habit, genetic, viruses or anything else. It's the way it is.

28:

Hmmm ...
I'm wearing the same size trousers I was 25 years ago.
I eat and drink, including lots of beer, quite a lot... it all seems to burn off.
I know I have a high metabolic rate.
Am I just lucky?

29:

It's kind of amusing in a depressing sort of way reading the article, talking about how people equate obesity to immorality, and then reading the comments... in which people equate obesity to immorality. I mean, the comments are steeped in it. Didn't the posters notice the irony?

While I'm ranting, why is everyone assuming that the obesity epidemic is due to any one thing? The universe is a complex place, and it's far more likely that there are a dozen different causes all mixed together. So we could have a different diet plus a cultural predilection to overeating plus a lifestyle more oriented towards a sedentary lifeplus hormonal effects due to industrial chemicals plus this virus plus umpteen other things that we don't know about yet.

Assuming that there is one primary cause for anything, whether it's obesity, climate change, the decline in bee populations or the inexplicable popularity of talent shows is a very dangerous mindset to get into, as it encourages polarised thinking --- if there is one cause, then all other potential causes must be wrong. We can see that happening right here; this report of a possible viral cause of obesity is being dismissed out of hand...

30:

No. This is about self f-ing control.

Lab rats are fat b/c we need to replicate human obesity for our experiments to be successful.

The animals outside are fat because they eat our trash, and giveaways (ask Yosemite or any other tourist park about this problem). Other animals eat these animals - thus their fat intake increases.

The epidemic is not about what el Pope deems as sin or as you state to be moral failure. People need to accept responsibility for their own destructive habits.

Fat people destroy more then their lives. They take down healthcare systems, research time and energy (that could be spent curing nasty diseases as opposed to make-me-rich diet pills). They should feel morally guilty.

31:

Yeah, that calories in = calories out is crap for some of us. I gained a lot of weight during the two long hospitalizations when I received nutrition via an N-G tube. For the big stroke last year I was in the hospital 26 days. The first seven I had IVs and the other 19 I had regular hospital food. I gained 25 pounds during those 26 days.

I'm not arguing that physics is wrong, but that there has to be more to that equation.

32:

If you don't get at least 50gr of protein per day, your body will start to deteriorate.

33:

I live in Japan, and am on the skinny side of normal.

When I spent two years in California, I went up two dress sizes. I wasn't aware of changing my lifestyle - this was Berkeley so I was walking everywhere up and down hill and as a penniless grad student I wasn't spending much on food - but I gained quite a lot of weight anyway. Within a few months of moving back to Japan, it had all dropped back off without any conscious effort on my part.

Same thing with my Japanese sister-in-law, who spent a year as a high school exchange student in Texas and ballooned in size. She came back to Japan and returned to her previous weight within a year, without dieting or doing anything special.

Of course there are obese people in Japan, and I know other Westerners who've put on weight after coming here rather than taking it off. But in my experience, the food culture here (ingredients and portion size) makes it easier to keep your weight down without having to try, whereas in the US and UK the opposite applies. I'm sure I'd have had to work very hard to get back to my original weight if I'd stayed in the US.

35:

Scared to back your words with your name, hmmm?

36:

I'm not detecting the sarcasm in this post. I feel I may have let myself down but it seems like you're suggesting weight gain is magical.

April seems ever such a long way away.

Enjoyed your tech articles, and the stuff about your books obviously, but this is legitimately insulting to my intelligence. Best of luck and all that!

37:

I do believe that a large part of the modern obesity epidemic is due to poor eating and a sendentary lifestyle. The proposition that other factors may be as much as an influence is interesting though.

It wasn't that many years ago that stomach ulcers were considered a result of eating fried or spicy foods. In other words, if you had an ulcer you had a failed lifestyle. Then it was discovered that stomach ulcers were caused by a bacteria and that a course of antibiotics was all that was needed.

So perhaps another factor in obesity isn't too far fetched after all. Curing obestity with antibiotics or anti-virals. What will the chubby chasteners turn their attention to then?

38:

I eat like a pig, and get no exercise except a 2 to 4 mile walk each day, broken up into several mile-long segments. I am trim to the point where people comment on it (at least while I'm wearing clothes).

I know a girl who runs five miles every other day, and who I have never seen eat anything but vegetables with peanut butter on them. She's fat.

I would not at all be surprised to learn there's something else to this obesity stuff.

39:

You might want to give this video a look if you're interested in the scientific research on this subject.

It's called Sugar: the Bitter Truth. The speaker is a Endocrinologist named Robert Lustig, and his opinion, based on a lot of advanced biochemistry I only barely understand, is that the obesity is caused by our increased sugar intake.

Not only that, but the idea of low fat diets is not only bunk, but that the sugars used to make our low fat foods not taste like cardboard is making us even fatter.

http://www.youtube.com/watch?v=dBnniua6-oM

40:

Another possibility is that there has been a spread of efficient gut bacteria. A course of Cipro with/ followed by acidophilus and/or other probiotics could be worth trying.

Some other unsolicited weight-loss ideas:

Start lunch and dinner with GIANT green salads; get a refillable pump spray bottle and use it to apply the salad dressing. You'll eat more, feel fuller, get more vegetables in your diet while still reducing calories. Try to keep your fat intake on the outside of foods so it's where you can taste it - you'll get sated more quickly, and it reduces the effective glycemic index of carbs, too.

Dry-roasted tree nuts are a good small snack to help keep your blood sugar up and also reduces overall calorie intake by being offset by less hunger and eating during regular meals.

Keep your protein intake high, around 80-100g per day - this supports the muscle mass that burns calories all day long. "Egg Beaters" or similar yolkless egg products are perhaps the most appetizing way to do this without too many calories or too much cholesterol.

If you exercise, don't just do aerobic, do some weightlifting focusing on the larger muscle groups (e.g. lat. pull-downs and leg press/curl - high enough weight that 3 sets of 8 of each is all you can do). Aerobic exercise actually can lower your basal metabolism, increased muscle mass increases basal metabolism.

Limit your beer intake - the stuff is practically designed to put on weight. A pint or two should be enough on weekdays, anyway.

41:

Lab rats are fat b/c we need to replicate human obesity for our experiments to be successful.

Rubbish. You've never worked in or around a pharmaceutical research lab, have you? Here's a hint: messing with the volumatic ratio of the aqueous/lipid partitions in a clinical model is not conducive to getting good pharmacokinetics out.

Finally: Yellow card for trolling. One more post on this topic from "No. Way." and you're banned.

42:

Ranting at people to stop sinning is a proven ineffective way to get them to stop sinning, or to solve any problem.

I mean, it's been tried over and over for thousands of years.

Why are people now fatter than in the past, or in the U.S. fatter than in Europe, etc.? Well, it ain't just cause people are more sinful now, or in the U.S., or whatever.

There are social factors that are correlated with obesity, though, including obvious ones like more automobiles and less manual labor. It might just be that obesity is a social price for getting rid of worse things - kinda like higher death rates from cancer are a consequence of not dying young from typhoid and smallpox.

And some less obvious ones like income inequality, which is pretty intuitive if you think about the geographical distribution of obesity, both within the U.S. and internationally. There's a book called "The Spirit Level" which has the actual statistical breakdown on that one and a lot of other unpleasant things that are correlated with higher income inequality.

Anyway, if ya actually want to solve a problem, rather than give yourself an excuse to feel better than other people: look for social causes (correlation it a good first clue for 'em) and then work for social solutions.

43:

I'm not detecting the sarcasm in this post. I feel I may have let myself down but it seems like you're suggesting weight gain is magical.

Yes, you're missing something: the irony, it burns.

(See also comment #36.)

44:

A virus you say? It is quite a strange virus then, which decides it much prefers to live in the U.S., most of the time, than in Europe.

Did you click through all the links about attempts to deal with obesity? Including the one to the obesity "hot spot" in Wales? (Which, I hasten to remind you, is in Europe, kinda-sorta ...)

While the obesity epidemic is leading in the USA, it's worth noting that the initial AD36 work came out of studies of avian obesity ... in India. Viruses, lest we forget, are contagious and pop up where different hosts come into contact with infection reservoirs. You might find some basic background reading on epidemiology informative.

Personally, I'd like to see a chart (preferably animated) of mean human BMI against geographical location over time. Ideally visualized as contours, as on a meteorology chart. Correlation against mobility would be interesting; ditto diet. I suspect we'd begin to see some interesting patterns emerge.

45:

Personally, I'd like to see a chart (preferably animated) of mean human BMI against geographical location over time.

Go find some economists, and get them interested in the subject. :)

46:

Oh come on. How can you possibly say that?

Ranting is a multi-billion dollar industry. We rant about over eating, we rant about drug use, and we even have things (like TSA) that make billions of dollars for private contractors. So far as I can tell, TSA and its ilk exist solely to be ranted about, rather than to, say, keep terrorists off planes.

Why are you against ranting? It's a proven route to money, power, and influence. What could possibly be wrong with that?

Besides, what else are you going to do? Sit down and have a rational discussion? That's no fun. Rational discussions are usually cost effective too, and we all know that profitable businesses don't like cost effective solutions....

Harumph!

47:

@ 31:

Yeah, that calories in = calories out is crap for some of us.

Well, no, it's really true, but:

I'm not arguing that physics is wrong, but that there has to be more to that equation.

This is much more accurate. How does a physicist answer a question like this? Probably with something like a bomb calorimeter for the input and er, output, and some combination of water bath and work meter. It's all about drawing the boundaries :-)

But that sort of approach - very accurate in it's own way - tends to erase a lot of distinctions. "Calories in" does not necessarily mean anything that passes through your lips, for example, and "Calories out" is more than just basal metabolism and conscientious exercise.

You've seen people fidget. They're the restless ones who can't sit still. They wiggle in their chairs, pace while waiting for a bus, and twist and fiddle while standing on line. Claude Bouchard is a scientist who studies the genetics of fitness and fidgeting. In his research, he has discovered that some individuals move more than others and that the tendency toward extra movement is determined by genetics. He has even found that fraternal twins (nonidentical) don't move the same amount. His conclusion is that some individuals are programmed to move more than others.


James Levine, MD, is a physician who studies physical activity and fidgeting. Dr. Levine has confirmed that heavy people sit more than lean people. In one study, he found that obese individuals sat nine and a half hours per day compared with lean individuals who sat less than seven hours per day.

So the gross physics can't be wrong - conservation of energy and all that - but the actual energy budgets can vary wildly in ways that aren't easily measured.

48:

Obviously eating right and exercising is what keeps most people healthy most of the tome. However it is important to remember we are basically glorified worms(digestive track) with an impressive casing(our bodies and brain) that itself is a casing for a multitude of symbiotic microbes all living in an ideally happy relationship to get food. We all have different gut microbes and metabolic pathways thus acting very differently to various foods we ingest. Research into these bacteria (acidopholus being mentioned earlier,) and other biota such as the virus also mentioned, could bear fruitful results to the obviously complicated and tangled web of metabolism and obesity. Perhaps particular diets suit different people based on their gut bacteria populations and their bodies relationship to them. It seems to me truly understanding metabolism will be biology's biggest key for developing human health and longevity.

49:

@ 42:

There are social factors that are correlated with obesity, though, including obvious ones like more automobiles and less manual labor. It might just be that obesity is a social price for getting rid of worse things - kinda like higher death rates from cancer are a consequence of not dying young from typhoid and smallpox.

Here in the states, obesity is also seen (by some) to be the social price of having two working parents. You can talk all you want about people having an irresistible craving for "empty calorie" fatty foods and everything from chips to frozen pizzas seemingly injected with high-fructcose corn syrup. But the fact of the matter is, more than anything else, they are cheap to store and cheap to prepare. Forty years ago, Mom might have labored an hour or so over a homemade pizza with salad for dinner and maybe cookies, pie, or cake for desert. Made from scratch, of course. Nowadays, Mom's just gotten through pulling an eight-hour shift herself. She's not going to make her own dough and roll it out after a long day at the office; she's much more apt to order a pizza to go for pickup on her way home, or to microwave dinner after some rather minimal preparation. And it is precisely those fatty, highly-processed, empty-calorie-laden foods that are the easiest and quickest to prepare.

There's your social cost.

50:

It is true that some people are more efficient at using up glucogen and turning fat into calories then other. Think about a Marathon sub 2:30 runner or even better an Ultramarathoner that can go non stop for 200k.. through exercise it possible to change how you use glucogen and how long you can actually last. But there are hard limits on that and they are quire well known

In the end in my own experience dropping about 30lb and being at my current weight for couple years without starving or anything like that. It was matter of not eating to full but to just relief hunger and feel ok and then running(a lot!). I was also commuting to work by bicycle 28k each way for a while.

51:

@ Evan RE: post 42

You should give that video link I posted a look. Here in the United States poor people get food support through WIC and Food Stamps. Sadly, they are allowed to buy soda through Food Stamps, and all sorts of juice are suggested for WIC.

But juice is healthy right?

No. It's all the sugars from fruit with all the fiber and most of the nutrients extracted. Juice is only marginally more healthy than Coke or Pepsi. When I give my kids juice it's just a way of getting water into them. I give them cups of about 80% water and 20% juice.

In addition, poorer folk tend to eat a lot more fast food and heavily processed food; ironic since this is a much more expensive way to eat. Those foods have a lot of Fructose, as in High Fructose Corn Syrup and many other variations. Fructose triggers a response from your liver (your liver is the only organ that can process the 'poison' of fructose) that causes release of insulin. If you have a lot of insulin in your blood the body gets ordered to store all calories as fat.

The only way your body can process sugars in a healthy way is if there's as much fiber as sugar. Like in fresh fruit for example, which again poorer folk don't eat as much of.

For the same reasons I don't let our public school feed my kids. The 'food' they serve there, which meets FDA standards, is absolutely loaded with sugars. Hell, they recently put Slushy machines in the damned cafeterias. Again, for kids living in poverty this is the only way for them to get lunch, and you can bet Cisco is fighting tooth and claw to keep cheap processed foods on that menu.

This is also, by the way, why a significant minority of vegans and vegetarians have as many or more weight issues as the rest of us. They can (and do) eat all the vegan cookies and other sugary treats in the world so long as there's no eggs or milk in them.

Exercise cannot make you thinner. Going for a five mile run will burn a few hundred calories. You can eat half a candy bar or a small fraction of any fast food meal and wipe that gain out instantly. It's entirely about what you eat. That said exercise WILL make you healthier and more active and do a ton of other wonderful things for you.

I have found that if I exercise I eat better, because in my own mind I don't want to 'waste' the exercise.

Also, at the various people who claim that they're so pure because they're thin and blah blah blah. I'm in reasonable shape myself. I swim or walk or run or bike just about every day. I eat right most of the time, but some of us are predisposed to being fat. We can't process sugars as well as the rest of you. I go on a low sugar diet and my weight is fine, the moment I start eating too many sugars and don't get enough fiber in my diet and I start ballooning, and this has happened when I was going for thirty mile bike rides every day.

You lucky bastards can process the sugars without bloating. Savor it while it lasts, the aging process will take it away from most of you.

52:

Personally, I'd like to see a chart (preferably animated) of mean human BMI against geographical location over time

I wouldn't. Not because there's anything wrong with study of such topics of interest, but because BMI is a crap measurement. It tells you very little, and most of that is wrong.

Doing the study with a meaningful measurement instead of BMI would be a lot harder, but it might actually tell us something worth knowing. BMI won't.

J Homes.

53:

This animated map of obesity trends in the United States is very interesting and a little frightening. It effectively refutes a lot of pet theories about single obesity causes. The first year with data for every state is 1995, and in that year every state had obesity rates under 19%. By 2009 only one state had an obesity rate under 19%, and several had rates over 30%.

Fast food isn't the smoking gun: it was already extremely common in 1995.
The automobile isn't the smoking gun: it was already extremely common in 1995.
Refined sugar isn't the smoking gun: it was already extremely common in 1995.
Loss of active jobs isn't the smoking gun: obesity has shot up sharply among too-young-to-employ children as well as adults. And there just weren't that many physically demanding jobs vanished since 1995 that they could account for the nationwide rise in adult obesity.

Maybe a virus is the missing smoking gun, or maybe there is no one smoking gun, just a lot of small changes that add up to a large collective obesity increase.

In online discussions of food habits I've frequently seen time and budget constraints blamed for forcing prepared or fast food on poor or heavily worked people, to the detriment of nutrition. But a microwaved potato or rice and beans hardly takes any more hands-on time to prepare than a frozen boxed entrée. It's also less expensive and lower in salt, fats, and sugar than prepared foods unless you go really wild with seasoning or toppings. It also requires only minimal cooking equipment and knowledge. That all this is true, and yet people rely heavily on expensive and fat/salt/sugar-loaded prepared food products suggests that taste preferences have a lot to do with why prepared products are so popular.

This study of dual income working families in Los Angeles indicates that convenience and prepared foods are neither necessary nor sufficient to save time.

Surprisingly, dinner didn’t get on the table any faster in homes that favored convenience foods. Meals took an average of 52 minutes in total time to prepare. The difference in the total amount of time expended was not statistically significant between meals involving extensive use of convenience foods (with such foods making up 50 percent or more of a meal) and more limited use of such items (between 20 and 50 percent).

In fact, families saved only when it came to the amount of hands-on time spent preparing dishes — and the savings were relatively modest. Families with an extensive reliance on convenience foods saved an average of 10 to 12 minutes over families with more limited reliance on such products. Home-cooked meals required an average of 34 minutes of hands-on time.

“People don’t spend any less time overall on dinner when they use so-called convenience foods,” Beck said. “Families seem to spend a certain amount of time cooking regardless. When commercial items are involved, they just ramp up how elaborate it gets.”

Additional research is required to pinpoint the exact reason no time overall was saved with time-saving foods, but Beck thinks the pampered palettes of today’s kids may play a role.

“Some people don’t fight the fight of getting the kids to eat what’s being served for dinner,” she said. “The kids frequently got entirely separate entrees or separate items from the adults, so that adds to the overall complexity of the meal.”

But the demands of serving as short-order cook only partially explained heavy reliance on commercially prepared foods. Other contributors seemed to include taste buds increasingly shaped by the food industry and dwindling reliance on grocery lists, Beck said.

“When you don’t make a list, you don’t know what ingredients may be called for,” Beck said. “So you grab food kits off the shelf. Then you know you have everything you need.”

Is this the final frontier of deskilling trends, a widespread inability to feed oneself starting from basic ingredients?

54:

One nontrivial aspect of this is that fatness gives people a target for hate and contempt that they can feel is legitimately deserving of it. Fat people themselves often absorb a lot of this, which does not make it easier for them to deal with their food behavior; huge levels of self-contempt seldom encourage rational choice. Part of this, I think, is that weight has become a class marker, in the reverse of the way it was two centuries ago, when the poor were thin because they often went hungry. Now the poor are fat, and being fat means looking poor—and striving to lose weight is a form of social signaling.

There was, for example, a news item about the psychological stresses of TSA workers who face resentment from people subjected to their new security theater routines. One quoted TSA worker expressed particular unhappiness about having to touch people of the same sex and fat people. The mere touch of fat was apparently traumatic. There are proposals to have psychotherapy available to help them cope with the stress of their jobs.

Is there any valid basis for the concerns about health? Yes, okay, I know people who weigh three hundred pounds or more; they face a variety of issues from diabetes to simple mechanical destruction of their own joint tissue. But I've seen reports that longevity is higher for BMI 25-30 than for the supposedly "healthy" 20-25. It wouldn't be the first time that medicine had been dominated by a scientific fad, or used to rationalize beliefs about "inferiority" that originate somewhere far less rational.

55:

Is it not possible to think of the obesity epidemic as a social problem without turning it into a moral issue? Because, really, a virus seems like a very implausible explanation and a desperate seeking of excuses.

56:

I think the fundamental problem is that food isn't energy.

I don't know enough about the physiology, but I'm doubt that you can get both the amino acids and the energy out of food, simultaneously. Ditto with vitamins. So I'm guessing that there are trade-offs between getting the energy out of food and getting the nutrients out of food. I'd love to know how much of both you can get.

The other problem is that gut organisms are involved in disassembling food, and I don't know what proportion of food calories are lost to their metabolism. I'd guess that you can get

So the problem isn't conservation of energy, it's figuring out how much of that energy is used, and where the rest goes. I'm pretty sure there's not a general answer (because everyone's gut is different, and physiological needs vary over time), but estimates are probably possible.

57:

Charlie, research suggests that obesity is not actually unhealthy; rather, it is caused by factors that also cause various diseases. CF http://jama.ama-assn.org/cgi/content/full/293/15/1861, and also the studies summarized at http://healthread.net/obesitystudies.htm.

The elephant in the room that the article you link to doesn't mention is processed foods. In every traditional culture that was forcibly converted by the imperial colonizers from eating a traditional diet to eating a diet based on white rice, white flour, and/or sugar, colonial doctors and missionaries noticed a sudden transition from no heart disease, diabetes, cancer, or obesity to a sudden spike in all four. The rational conclusion is that processed carbohydrates are a major factor causing these "diseases of civilization" and are very bad for you (cf, for instance, part II of Michael Pollan's "In Defense of Food").

And the ratio of processed carbohydrates in human food have been doing nothing but going up, because they are a cheap way to make something marketable as "low in fat" and thus allegedly "more healthy." Ditto in pet food, for the same reasons. If the ingredients in lab rat chow have been changed at all over the time span of that study, that's probably a significant aspect of the explanation for the rise in lab rat weights right there.

Finally, there's the curious fact that physiologists doing basic research have known since the 70's that the ONLY biochemical trigger that causes fat cells to take up fat from the blood stream is elevated insulin levels, and the overwhelmingly primary trigger that causes them to release fat back into the blood stream is low insulin levels. Which explains why low carb diets work, and a great deal more. But somehow this extremely revelatory fact has failed to percolate into the medical literature, or into basic education health classes, in any real way (cf Gary Taubes, The Diet Delusion aka "Good calories, bad calories").

Basically, the entire field of weight and how it relates to health is a prime example of the way bad and inaccurate research lives on and gets cited in medicine to a much greater degree than in any other field of science (cf http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124 )

58:

I suppose I see the "virus" and "endocrine disruptor" theories as another version of the sin-and-redemption model of obesity. The version where one is caught out and start desperately making excuses.

59:

So any form of medicine that we cant explain how it works is invalid?

Your having a go at biofield medicine because it doesn't fit within your paradigm and "both of these are based on models that just plain don't work — they don't match what we know of biology and chemistry these days"

so tell me which is correct quantum theory or relativity? Which paradigm is correct? Please integrate these two conflicting paradigms so they are consistent. Or is one wrong and the other right?

the problem with people who profess to believe in 'science' is that they often believe the current paradigm is the 'truth'. They explain away other paradigms as mistakes, when within that paradigm everything was rational and made perfect sense of the world and any other view of the world "plain don't work — they don't match what we know of biology and chemistry these days"

The problem is that acupuncture does work, it has been shown repeatedly to work, of course we cant exactly say how exactly it's working in "what we know of biology and chemistry these days". There is a paradigm that does explain it, but talk to a Chinese doctor schooled in both paradigms and they will recognise the conflict. My acupuncturist uses one paradigm whilst happily accepting that it makes no sense in another paradigm. The paradigm works even if cant be explained in another paradigm

To give a similar example please explain how psychiatry/psychotherapy works? There is some evidence that some cbt works in some limited situations with some kinds of fairly minor thought disorders. But a lot of therapy is unprovable however people clearly get better as a result.

60:

Is there any suggestion as to how the virus might work - by changing the efficiency of metabolism or by changing people's behaviour? I find it hard to believe that if we could be much more efficient we wouldn't be - enough people have starved to death in history to make that a strong selective pressure.

I've got sympathy with views from many sides expressed here. You can lose weight by smallish dietary changes and exercise: I've got my blood pressure from worrying to normal in 9 months by losing over 10kg and getting fitter. I've done that by restricting snacking (so I still eat well and enjoy some drinks) and stepping up gentle exercise in normal life (I walk about 10-15 miles a week more than I used to). I've now - officially by BMI - only borderline obese. I intend to lose a bit more, but if I was to get down to 25 I'd be emaciated. But I was lucky - I don't like sweet food much (I'd always rather have more of the main course than a dessert), so avoiding the biscuit and sweets and cakes people bring into work was a lot easier for me than for many.

But, like Charlie, I can point at the moment when I stopped being able to eat anything and everything and remain like a stick. It was in February 1984 when I had all 4 wisdom teeth out, in hospital, and subsisted through a straw for a week or so. After that I started to pile the weight on. I always half-wondered if some sort of "starvation programme" got turned on and has never shut off, but - off course - hospitals are good places to catch things.

61:

How would a physicist answer the calorie in/calorie out equation?

Like this:

http://entropyproduction.blogspot.com/2009/02/all-medical-science-is-wrong-within-95.html

"Surely the nutritional scientists did not not really believe this, right? I mean, any idiot undergraduate students knows that the 1st Law is only useful in a closed system, and humans live on the planet Earth, not in an insulated box. Right?

... Unfortunately, to a physicist this energy balance hypothesis looks like a silly hand-waving exercise, not a serious argument ... This conservation of energy argument is on the same scientific level as the ridiculous "drink cold water to lose weight" idiocy."

It's not a virus. It's the same reason you can gain 25 pounds in 25 days eating hospital food. It's the link between carbohydrates, insulin, hunger, and weight gain.

As someone who both loves and reads Mr. Stross' work and is paid to train people to look, feel and perform better, please take it from me that to tell a client to 'eat moderately, work out regularly, and exercise your willpower!' means I would be out on the street starving because it quite simply does not and will not work.

I see immediate results with moderate (2-3x/week) strength training and the elimination of refined carbs and grains from the diet ... and all this while clients eat to satiety. That's it. No treadmills or calorie counting.

If in doubt, get your insulin sensitivity checked.

jason

62:

@ 2
"Exercise"
I take NO exercise in the deliberate sense of the word.
But - important - I have an allotment, I'm trying to continue re-decorating my house, almost all my local journeys are done by bicycle, and going into central London, I use trains/walk. Most weeks, I also do an hour's dance-practice, or "dance out" if it is Spring or Summer-time.
Diet: from above, we eat alomost no processed food at all, and we usually know that our meat/fish intake is from known/traceable sources.

@ 11
BMI
This is a load of crap.
My BMI is 25.6 - yet see above.
BMI numbers were calculated from a starved population - that of the US mid-west during the dustbowl.
Oops.

@ 17
You have something seriously wrong with your metabolism and/or food inputs if it as bad as you say.
It suggests your medicos are looking in the wrong place.

@ 26
You are correct, in that a BMI in the 25-29 range is probably optimal. Food intake - everyone concentrates on "calories", and FAT. But in the US, and to some extent here, it is SUGAR(s) that are put into processed foods which are the villains of the piece. Plus other additives, of course.

Marilee @ 31, 32
And how much exercise, even just walking around, did you get/do whilst in hospital, hmmm?

@ 39
I think you have hit it - for most people, at least.

EH @ 40
BOLLOCKS
Limit Beer intake to a couple of pints during the week?
What are you, some sort of mad puritan?
See my comments on my shape/diet. I take about 40 "units of alchohol" a week, sometimes more ....

@ 46
Love it!

@ 49
Can I add central heating to your list?
Warmer houses means less shivering (which uses up food/calories) and less exercise of any sort.
Leads to small food-surpluses, and hence weight gain.
AND
You mentioned high-fructose corn syrup - this IS the US, right?
EUGHHHH ....
Ditto @ 51

@ 52
See my comment (above) about the valueless nature of BMI and why.

63:

Here in the states, obesity is also seen (by some) to be the social price of having two working parents.

If that were the true, everybody in former socialist countries would have got fat a long time ago.

64:

In regards to AD36, the original researcher was an Indian scientist who was working on an all together different virus in chickens. Then he moved to the US and couldn't get permission to bring the virus over so he and a colleague randomly selected a bunch of adenoviruses and went down the list for which ones they could get hold of. AD36 was one of them and it was tested in some animals that did get bigger (though exactly why has not been discovered and the effect of this virus is unknown).

He then went on to make a documentary where he tested a selection of obese Americans and told them if they had signs of an adenovirus inside them, before telling them that this was why they were obese.

Not very good science, especially mixing it with a documentary and making such powerful claims as his virus definitely caused their obesity. Obesity like any condition is [b]multifactoral[/b] and its important to reign in on any conclusions until far more research is done.

65:

You do realize that any claim that body fay and total mass can not be controlled by varying caloric intake and activity level / caloric consumption / workout is based on the concept of perpetual motion.

No matter what the contributing factors are that "make it hard" you are not able to create "free energy" that you can consume or store as fat.

66:

At least some fraction of the health problems associated with fat are the result of prejudice. Being hated is hard on people, both emotionally and physically.

In particular, it's difficult for fat people to get decent medical care. They're very apt to be told to lose weight first, no matter what symptoms they show up with. This means that serious problems may not be addressed, and also that some fat people give up on going to doctors.

There are doctors who don't assume that fat is the source of all health problems, and it's worth tracking them down.

At least in the US, the belief in low-fat eating may be part of the problem. The easiest way to make low-fat food relatively palatable is to add sugar/corn syrup.

67:

So the gross physics can't be wrong - conservation of energy and all that - but the actual energy budgets can vary wildly in ways that aren't easily measured.

Actually, Calories in = Calories out is wrong, if you think of it solely in terms of human metabolism.

We all host complex microecologies in our guts -- 1.5-3Kg of bacteria and eukaryotes. Those guys are intimately involved in our digestive processes, and they have metabolisms, too. They get to the stuff we swallow before we do, insofar as they reproduce in the soup of semi-digested chyme in our intestines before and while we absorb the useful stuff through the villi lining our duodenum. They've got their own energy demands, and they may assist or hamper the digestive process and raise or lower bioavailability levels for some micronutrients.

They don't have to metabolize all the stuff you throw down your throat to stop it getting into your bloodstream and feeding your own metabolism, they just have to render it unavailable, for example by absorbing it until you excrete them (and it) twelve or so hours later.

Our gut bacterial cultures are all subtly different: there are a couple of hundred species present in a typical human gut. Some are more efficient at sequestrating metabolites than others. A human host carrying an "efficient" bacterial culture will absorb fewer nutrients following a meal than a human host carrying a less-optimized culture after an identical meal.

68:

Not arguing over the usefulness of BMI, but it's a useful first step because it's data that is already available, because historically BMI is the data that has been collected.

There are two ways to max out your BMI -- pack on the fat, or hulk out by body building/muscle development. The latter is what invalidates BMI as a useful correlate for obesity. But the former is generally a lot commoner among the general population. By tracking the proportion of body builders in the general population over time, we ought to be able to control for it, and get a derived figure for mean BMI excluding body-builders.

Which, if nothing else, will give us a rough unidimensional handle on how things are changing over time in any given location.

69:

Is there any suggestion as to how the virus might work - by changing the efficiency of metabolism or by changing people's behaviour?

What speculation I've read centers on AD36 disrupting fat sequestration/mobilization in white or brown adipose cells.

See edit near the end, where I cite the abstract of a paper researching the effects of AD36 in vitro. The researchers identify a mechanism by which AD36 induces adipogenesis (fat globule formation) in human adipose-derived stem cells.

70:

Kate, if we can't explain how a mode of medicine works, and if there's no evidence to demonstrate that it works, then it's invalid. If its efficacy is indistinguishable from the placebo effect, then fine: it's a placebo. And if it's placebo-equivalent and postulates a model of the human body that is at odds with what we know of physiology, cytology, and biochemistry, then it's probably wrong.

Acupuncture does work -- you'll notice I didn't mention it -- and there are a whole bunch of studies demonstrating this, and proposed mechanisms (direct stimulation of nerves triggering endorphin release in the brain for pain release, for example).

What I'm taking issue with is shit like crystal-fondling and mystic woo about "energy fields" that, oddly, don't show up in MRI machines and rely on a model of physics that was disproven by the Michelson-Morely experiment, if not earlier.

(Rant triggered because yesterday I found myself in a coffee shop that rented out their basement to a clinic, and found myself reading the clinic's blurb. Basically they do relaxation/massage therapy by laying you down and putting hot stones on your back. So far, so good: I can see that being relaxing. But then they launch into a bunch of woo-woo about how the magnesium and calcium in the special rocks they use (lovingly quarried by hand from a traditional mine in China) channel the energy fields feeding your natural aura and purify the chakras. Please to be showing me a natural aura, preferably on a diagnostic instrument that isn't on the blink? And please to be explaining to me what this blurb means, other than "we're going to massage you with hot rocks, and justify ramping our rate 250% over a regular massage by feeding you some mystical guff".)

71:

#65 Para 4 - Nancy, I think you might be on to something here. The "obesity epidemic" does (from memory) seem to link with the rise of the "fat in food police" and, to a fair extent, the rise of "cook-chilled" fresh "ready meals".

More generally, I personally suspect that our minds are long-term hard-wired to consider "over-BMI" as "healthy", because historically this was the case.

72:

Charlie, I promise this isn't a troll, but a statement of facts.

I agree that there's no presently effective way of detecting chakra, Qi etc energy fields. That said, I did once work with a bloke who was a karate black belt, and was asked to leave the dojo (by the guest sensi [sp]) for a blindfold demonstation because of the strength of his Qi. If you'd met the guy, you'd find this tale pretty much entirely believable, because there was something about him that you could just feel was different to better than 99% of the general population (including most martial artists [and I've known a number of them down the years]).

73:

And thus we get derailed onto "Qi is real" "No it isn't" "Yes it is" discussions. Which so far to me seem to be convincingly against it being real, except insofar as humans acn convince themselves of a lot of things.

The issue with accupuncture is that it works, but the theory behind it is almost certainly completely wrong. Historically speaking, the spots to stick the needles in have changed over the years, and trials done with everything from fake needles to stabbing odd spots seem to show that its a mix of placebo effect and what happens when you get endorphin releases from being stabbed with needles.

We see the same problem 500 years ago with metallurgy - the overarching theory of matter was wrong, but things still worked because most stuff could be crammed into the paradigm. Or a more modern example, I read somewhere that Steiner schools are quite good, but if you read up on Steiners theories they're batshit insane. Its entirely possible to be doing something that works despite your theory of why and how it works being wrong.

74:

Interesting take on acupuncture-- claims that traditional Chinese medicine doesn't include mysterious energy fields, and offers an explanation in terms of the nervous system.

Two other factors in the "epidemic": Dieting-- it looks as though some people regain extra weight after dieting. Go through that cycle three or four times, with an extra 15 or 25 pounds each time, and it's a substantial weight gain.

Prescription drugs: a number of commonly prescribed drugs have weight gain as a side effect.

75:

Or rather, regarding metallurgy (Since i realise I didn't explain it clearly enough), the stuff worked, the theory seemed flexible enough to cover most of what worked and what it couldn't cover it could be stretched to fit. I'm sure pro-homeopaths, accupuncture and other such people will complain that modern science is being stretched too far or cutting too much out of the paradigm.

76:

What if something in our environment kills the less efficient ones? Or, perhaps invalidates their chemical warfare strategy?

77:

This is much more accurate. How does a physicist answer a question like this? Probably with something like a bomb calorimeter for the input and er, output, and some combination of water bath and work meter. It's all about drawing the boundaries :-)

Indeed, there is caloric content in solid (and semi-solid) waste, otherwise the popular "use dung for fires" wouldn't work.
Although I understand there are scaling factors applied, these days, for "average human metabolic uptake of".

<speculation type="blatant">There may well be large per-individual differences in how good digestive systems are at extracting the energy in the food</speculation>

78:

[3] Let's not underestimate the lethality of the obesity epidemic. Obese people are more likely to suffer from diabetes, cardiovascular disease, and joint damage. These are all contributors to premature morbidity and mortality. In fact, the total years of life lost to premature mortality among 2-3 billion victims of an obesity virus would be similar to the years of life lost due to diseases such as AIDS or malaria (which are significantly more immediately lethal, but infect a smaller pool).

Actually, I'd turn that one around: people who have insulin-resistant diabetes (such as the varieties lumped under type II diabetes, and the type which is part of a diagnosis of Polycystic Ovary Syndrome), people with cardiovascular disease, and people with joint damage are often more likely to be obese. Part of this is due to simple biological factors - insulin resistance interferes with the glucose/glycogen storage and retrieval cycle; cardiovascular disease can make it harder to exercise due to circulatory problems; and joint damage makes any form of motion more painful, making it harder to burn off energy at all. Add to any of these the necessary amount of calories required in order to avoid various nutrient deficiencies and the diseases associated with them, and yes, there is likely to be some kind of weight gain.

Claimer: I definitely have a dog in this fight. I'm fat, I'm female, and I have an underactive thyroid, which I strongly suspect is a result of the ten years of dieting I undertook between the ages of thirteen and twenty-three. I gave up dieting when I realised ten years of dieting had caused me to gain 50kg - or in other words, when my weight had doubled. When I gave up dieting to lose weight, I stopped gaining it too - I've been the same clothing size for well over 10 years now. By the bye, I'm also disgustingly healthy otherwise - the only reason I see a doctor most of the time is because I need to get repeat prescriptions of my thyroid and anti-depressant medications. Wasn't for those, I'd not have been next or nigh a surgery for at least five years now.

79:

Possible, although I'd take issue with the phrase "chemical warfare strategy" -- these are commensal organisms, endosymbionts when they're confined to the gut (dangerous infective organisms if they get into the general circulation or the peritoneal cavity, but that's another matter). They're effectively a closed ecosystem of microbial heterotrophs, and they absorb a lot of the nutrients in our food and use them to make more bacteria (which end up being shat out the other end), not just for energy.

The whole calorie-counting culture relies on the simplifying assumption that if you put some quantity of glucose in your mouth, eventually 100% of it will end up in your bloodstream and contribute to your metabolism. This isn't the case. Digestion is less than 100% effective, absorbtion of digested food is less than 100% effective, there's parasitic drain from our gut culture, and other effects can cut in (if you've got violent diarrhoea, the odds are high that nutrients aren't going to stick around in your gut for long enough to be absorbed).

One way of looking at things is that fat people have more efficient digestive systems -- they absorb what they eat more efficiently than the skinny beanpoles!

(I see that Vatine @77 is also all over this one.)

80:

Wow, this is a really, really interesting discussion.

Charlie - I'm not a body-builder, per se (and frankly I don't really fit the "serious martial artist" tag either, since at best I train twice a week), but my BMI comes in just under 30. I'm also not fat, at least as far as anyone can tell without doing conductivity tests. I may be very unusual in this, but it does cause me to doubt BMI somewhat.

81:

I just thought I'd tally the various explanations that have been mooted so far for obesity in this thread.

So far, we have:

- "You're just lazy" (I think we can discount this one)
- AD36 or other virus
- Sugar in diet
- Fidgeting or lack therof
- Refined foods (white flour, white sugar, etc)
- Insulin
- Carbs or lack therof (I initially typoed that as "cars or lack therof")
- Room temperatures
- Portion Size (US/UK compared to Japan)
- Processed food in general
- Changes in gut bacteria

Not wanting to hijack Charlie's thread, but I'm wondering if anyone has supplementary personal evidence for or against any of these being a factor?

For example, from my lifestyle - I'm not obese, at least by the "you have lots of fat on your body" standard of obese (see above). I tend to prefer and seek out cold to very cold rooms, I eat massively less processed food than most people (I really like cooking), I eat pretty gigantic portions, and I don't have a sweet tooth to the point that unless my girlfriend suggests it, I'll almost never buy anything with tastable sugar in it aside from smoothies.

82:

Ont of the issues with BMI is that muscle is denser than fat so if you are well muscled, your BMI will be higher.

83:

Yeah, I get that - however, I've heard from various people (including Charlie above) that you basically have to be a serious weightlifter to cause the needle to wobble on the BMI scale. I'm not by any stretch of the imagination a powerlifter - is it the case that "moderately well-muscled" will have the same effect?

84:

There are a lot of comments here, and so I'm skipping past a lot of them to make my point, so please excuse me if I'm repeating anything that's already been said here by someone else.

About four years ago, I was definitely sliding into general podginess. I didn't think I was at the time, but I was, as is clear from looking at photographs of myself from that period. Now, I'm a lot thinner. Not quite skinny - there's still some extra fat deposits I'd dearly love to get rid of - but between then and now I shed at least a couple of stone.

The trick was moving country. I lived in the Far East, Taipei in Taiwan to be specific, for two years. I ate mostly local food which, to my decidedly inexpert knowledge, is very low on fat and very, very different from Western diets that are heavy on things like wheat and milk (barring noodles, of course).

The weight dropped off me in the space of several months. When I came back to Scotland, I saw people's jaws collectively hit the floor when they saw how much weight I'd lost. More than that, a few weeks after coming back, almost everyone I saw looked...kind of heavy to my eyes. And I mean everyone, with few exceptions.

For that reason, I'm strongly inclined to the idea that the problem is not some virus, but something dietary. Unless, of course, it's a virus that doesn't affect people not from Europe or America, and happen to eat a completely different diet.

It would also have to be a virus that stops working on people who change their diet to a much healthier one (given, or so I'm under the impression, that Asian dietary habits are generally far healthier than those in the UK or States). In that case, it would be a remarkably *picky* virus.

The material about laboratory animals and so forth is certainly interesting, and potentially worrying, but this early in the study I'm inclined to wait and see if there prove to be flaws in this research. My opinion may be based on personal anecdote and experience, but given I went from fat to thin in a country filled with thin healthy-looking people, then personally I'm ruling out either viruses or genetics.

85:

I have seen famous actors gain dozens of kilos for a part, and then shed the weight for the next part. This anecdotal evidence suggests the most potent ingredient in a weight loss diet may be willpower.

86:

Nope: the problem with dieting and rebound weight-gain is well understood; you might want to read up on the Minnesota Starvation Experiment, and the subsequent history of the test subjects. (Briefly: yes, you can starve yourself and lose lots of weight. Trouble is, doing so primes your metabolism to put weight back on as soon as you come off the starvation diet. This, incidentally, is why the diet industry is such a good money-maker: you can get folks with serious body-image problems hooked on a repeated cycle of diet-followed-by-rebound.)

87:

Don't forget the "social contagion" theory, derived from data from the Framingham Heart Study. (The facts that the effect was the same even when people lived hundreds of miles from each other, and that it also applied to weight loss, seem to undermine the virus theory.)

http://www.nytimes.com/2007/07/25/health/25cnd-fat.html

Study Says Obesity Can Be Contagious

By GINA KOLATA
Published: July 25, 2007

Obesity can spread from person to person, much like a virus, researchers are reporting today. When a person gains weight, close friends tend to gain weight, too.

Their study, published in the New England Journal of Medicine, involved a detailed analysis of a large social network of 12,067 people who had been closely followed for 32 years, from 1971 until 2003. The investigators knew who was friends with whom, as well as who was a spouse or sibling or neighbor, and they knew how much each person weighed at various times over three decades. That let them examine what happened over the years as some individuals became obese. Did their friends also become obese? Did family members or neighbors?

The answer, the researchers report, was that people were most likely to become obese when a friend became obese. That increased a person’s chances of becoming obese by 57 percent.

There was no effect when a neighbor gained or lost weight, however, and family members had less influence than friends.

Proximity did not seem to matter: the influence of the friend remained even if the friend was hundreds of miles away. And the greatest influence of all was between mutual close friends. There, if one became obese, the odds of the other becoming obese were nearly tripled.

The same effect seemed to occur for weight loss, the investigators say. But since most people were gaining, not losing, over the 32 years of the study, the result was an obesity epidemic.

88:

Gary, there are other possibilities that you missed: notably the effect of a change of diet on your gut microecology. Before going east, you were used to a Scottish diet -- and so were your gut bacteria. Then you presented them with a changed diet, forcing a major rebalancing of their microecology. Trouble is, working out how our internal microecology works is difficult (go on, click the link).

89:

Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explains how since the 70's fat consumption has decreased, yet obesity has increased. "It ain't the fat".

http://www.youtube.com/watch?v=dBnniua6-oM

to summarise it's the increase in sucrose and especially fructose in our diets

90:

#73 Para 1 - That wasn't my intention. What I was saying was that I've met one individual in my life to date (out of probably thousands in total) that still stands out because of something about their "presense", but which you couldn't measure using instrumentation. The reason for assigning the word "Qi" to it was as much due to the karate link as anything else. It's a personal account of a case which makes me think that there may, note may, be things about the human body that we still can't measure.

91:

Even Japan is getting an obesity problem these days. The diet hasn't changed that much, and the junk food was added a long time ago.

92:

If there's a virus or bacteria out there that makes our digestion more efficient we probably should look into it.

I mean, it's only "maladaptive" to be overweight in a very restricted contemporary social context, as others have pointed out being slightly overweight is probably healthier, and an optionally more efficient metabolism has to be a good thing to have in our armory if Malthus comes knocking on our door again.

93:

Interesting discussion. Just to add a little more trouble to the multifactorial pile, there are studies showing that people with fat friends (including online) are likelier to gain weight. So perhaps part of the process is some kind of runaway positive feedback: a few people get fatter due to any of the issues talked about earlier, thus leading to people readjusting their notion of normal weight, thus leading to them gaining weight, etc.

Speaking for myself, I suppose I'm quite fortunate: I do very little exercise (mostly sit and lie), am very cold-prone, eat as much as I like of whatever I want, and my problem tends to go the other way. I find it incredibly difficult to go over 60 kilos, and there have been points in my life when I thought I was dangerously light (felt even colder, tired, weak, etc). At that time I went to have medical checks and they didn't find anything odd, fortunately.

94:

I'll fall into the "eat less, weigh less" camp - and while I'm perfectly willing to acknowledge links between insulin levels and fat storage etc, but fundamentally it has to come down to whether you're running an energy surplus or deficit.

Think of it from another direction. Do Olympic athletes have low body fat because they train hard and eat sensibly, or is it a physiological fluke? Do those who have been forcibly starved without the opportunity for midnight snacks (see: Burma Railway, Belsen, Omarska) have low body fat in spite of their physiology?

I'd suggest that Ayse@17 is _not_ "only consuming 900kcal a day, and exercising 5 hours a week" to stay 20kg over ideal - applying Occam's Razor would suggest that an uncounted source of calorific intake is more likely than "starvation diets don't make you lose weight". Some people will calorie-count their salad but forget to count the calories in the salad dressing or perhaps associated glass of wine...

In my twenties, I did a lot of physical exercise, and ate healthily. My body fat sat at well under 10%, and my VO2max was in the high sixties.

As I exercised less, I gained body fat and lost cardiovascular fitness. I was still eating to the same pattern.

These days, my weight is static, but I'm fairly sedentary. I eat far less. Operating on a fairly steady exercise rate, when I eat more, I put on weight; when I eat less, it goes away.

Let's not just talk about the "sin" aspect of obesity; there's a good living to be made in telling people that they don't have to feel guilty about something - see the "Daily Mail" and frequent stories about work-shy scroungers and benefits fraudsters (subtext: don't feel guilty about poor people, it's their own fault).

95:

I've read a fair numbers of accounts by people who attempt fat loss. Some succeed, some fail. Some maintain a fat loss indefinitely, some find that it's not worth the effort in spite of huge social pressure.

Weirdly enough, I think a lot of these people are telling the truth about their own lives.

And if intentional fat loss were a drug, I don't think it would pass the FDA, considering the low rate of effectiveness and the side effects.

96:

An odd thing to comment on because this is the day of overeating, Thanksgiving, in the U.S. As if we don't consume more than we need at any other time of the year as well.

OK, first, to Roy@26. I would caution all women that men lose weight faster than we do; so, do use portion control and calorie counting, but be prepared for the Dread Plateau to hit faster than it does in a male body.

One thing we do not mention is high fructose corn syrup - an insidious ingredient in almost every pre-made food out there. Grow your own veggies; learn to bake and to cook and get away from the fast food. I can make the feast for the above-stated holiday with 1/4 pound of butter and 1/2 cup of organic brown sugar and about the same amount of honey and I've done pretty well.

Am I a skinny person - no, never have been, but I have low blood pressure, cholesterol count that would have been considered normal before Big Pharma needed to sell more statins and did all of those studies about how we should be in the 160s or lower (BS, again especially for women).

Diabetes: it is hard to avoid adult onset if you are overweight; but you can by exercising. Since I am disabled and walk with a cane, I find that an elliptical trainer with handles to hold gives me a place that is safe for an hour's walk. We are installing an all-in-one gym station so that I don't have to worry about weights falling (also in my 60s) because we need to do weight training or we lose muscle.

Don't overfeed your pets. Remember that their stomachs are small - proportionate to their size. Cats do well with the food picked up after meals. I also add goodies to their canned food like lecithin granules, brewer's yeast and salmon oil. I can't attest to the longevity of these two, as we have just adopted and they will be 8 months on 01/12. Nevertheless, they are growing well and are happy and active. Our last two kitties lasted to 21 and 17 respectively (bone marrow cancer cut our last one's life short).

So, no fast food, learn to cook, grow at least your tomatoes and lettuce and green onions (all do well in pots if you've no place to do this), do not overeat and don't let your pets overeat. We could get into psycho-social problems we (especially Americans) have with food, but I'm off to cook my turkey in my neat, low-fat way... Happy Thanksgiving to you all.

97:

@paws4thot: I recall seeing videos of "Qi masters" supposedly projecting their "Qi" at people and making them fall down. Initially I thought it might be faked, but then I realised there is another explanation which fits the facts: hypnotism.

Derren Brown's videos are full of examples of him gaining people's full compliance with a touch or gesture. And he also has an uncanny presence, a suggestion of not-quite-normal about him.

Back in Mesmer's day people thought that hypnotism was something to do with magnetic fields. It's natural to think that if there is a cause (the hypnotist), and an effect (the subject), there must be a direct causative agent (mind rays!) between them. But it's not necessarily so. Nowadays we accept that it's real, but entirely psychological — nothing more exotic than what you say and do, and the way you say and do it.

This doesn't make it any less impressive, though, or any less effective.

98:

I propose a simple explanation for the increased weight of lab rats - we don't treat them as horribly as we did 30 years ago. One thing that certainly has changed over that period is the social acceptability of some forms of violence.

99:

An odd thing to comment on because this is the day of overeating, Thanksgiving, in the U.S. As if we don't consume more than we need at any other time of the year as well.

Dude, I'm not American, this isn't the USA, and we don't celebrate Thanksgiving in this country.

So there.

(Also? HFCS in food as a bulking agent is a peculiarly American thing -- buy processed foods in a British supermarket and and American one and compare them for flavour, and all the American ones taste cloyingly sweet.)

101:

Another interesting theory: The increased consumption of industrial seed oils, especially Omega-6 rich PUFA, is responsible for the obesity epidemic. Nicely explains the French paradox (they love their saturated fats) and the leading role of the US in the obesity departement (deep fried everything and by far the most saturated-fat-is-evil-propaganda).

http://wholehealthsource.blogspot.com/2010/04/do-seed-oils-cause-multi-generational.html

102:

Personally, I think the problem is much simpler than all these explanations: agribusiness is fattening you hominids up.

Croak!

103:

well those BMI tables, from what I remember were drawn up around ww2.just after a 'famine' or sorts
plus they dont seem to follow the rule about size/ volume very well

104:

Guthrie @ 73
Like string theory, you mean ?

Chrlie @ 79 & others ...
Commensals.
Well, some can do you a nasty, and you might never realise. For about 10-15 years, I had a "grumbling" gut, and had occasional times when I really wasn't sure if I dared stray too far from the bogs, or alternativly had gripes/cramps. Autumn 2008, I picked a Bolete fungus I thought I'd eaten before. I checked carefully, it was, but the details reminded me "some people react badly to this one" - so eat a small piece - ok. Next day I eat the rest of it (it was a big one). That cleared me out, I can tell you ... but my grumbling-gut problem went with it.
I'd, quite obviously, had an irritant bacterium living inside - and now got rid of.
How many other people have these problems, I wonder?
Charlie's forwarding of the virus-hypothesis for obesity suddenly looks quite a reasonable prospect.

@ 82/3
Yeah BMI if fit and muscled (even a thin weed like me) will push the number up.
I thought it was well-known that a single marker-number or factor is usually a very bad way of evaluating anyhting except the simplest problems. (Something the politicians ignore all the time)

@ 96
Cats:
"Human food is better - best of all if we can steal it"

@ 97
Hypnotism?
Really?
Only if you are gullible and/or prepared to believe in it, surely?

105:

I can't remember where I saw it, but somebody rather insightfully compared our view of obesity to our past view of alcoholism. We used to view it squarely as a vice, a sin — "drunks" were characterised as lazy, as having no will-power, of lacking foresight. Then at some point there was a sudden cultural shift and these same people were not "drunks" but "alcoholics", not sinners but victims, and not lazy but rather heroically struggling against a very real disease. The same author then noted the rising anger and scorn directed at the obese, and hinted that society had not become kinder, but simply shifted its focus onto a more fashionable scapegoat.

That's a simplification, of course, but it's an intriguing angle. And extending the comparison leads to an another interesting questiong: has alcoholism increased or decreased since we as a society stopped demonising alcoholics? That's actually a pretty hard question to answer, and despite what the Daily Mail might have you think, my guess is that in most western countries it's actually held fairly steady. If so, then we might by analogy conclude that in fact it doesn't matter whether or not you blame the obese for their own misfortune, it's not going to make us as a society any fatter or any thinner.

(Of course, if it doesn't matter, then why choose to be an arsehole? We'd all be happier if we just minded our own business.)

106:

The fear culture may be playing a roll in the United States, sedentary children are tolerated to an extant that would not have been imaginable 40 years ago.

107:

I was thinking specifically of children and animals. Being cruel to the poor remains popular.

If you want an example, consider that the Animals (Scientific Procedures) Act was passed in 1986 and the number of permits issued every year has been falling steadily. Also, the Act itself has been substantially extended executively since '86 - Michael Howard famously added Octopus vulgaris to the list back in 1993, making it the only invertebrate with legal rights.*

20 years ago you could chop up chimps in the name of science in most of Europe, now you can't.

*This fact should surely make it into a Laundry novel at some point.

108:

is this the next step in human evolution?
Man-Plus?

in all ways possible..

109:

We could call this the Principle of the Conservation of Outrage.

I expect that we'll see a similar effect with regard to homosexuality/bisexuality/transsexuality/hey, sexuality in general, dammit. As people get over that one, they'll seamlessly transfer their sanctimoniousness (sanctimony?) to some other target. At the moment it appears to be financial misfortune, howsoever caused, that's likely to take up the slack.

110:

@Greg: Hypnotism might not work if you consciously choose not to allow it to, but anecdotal evidence suggests that it works by default. Humans in general seem pretty willing to be manipulated.

111:

Nope - paedophilia.

It also seems to be so concentrated that even a suggestion that someone might be a paedophile may raise the outrage to lethal levels.

112:

>Derren Brown's videos are cherry picked from an unknown number of runs, then edited for TV.

FTFY!

113:

#97 - Ok, a bit more detail then.

The guy who told me this story was someone that you would be more than averagely aware of when he was in the room. He was far from the only person I shared this office with. Hypnotism doesn't come into whether or not you are aware that someone is in the room.

114:

Clearly the fat/muscle confusion inherent in the BMI index needs to be combined with a test that's a little more... medieval. Into the duckpond with you! If your copious flabby bits cause you to float, you be a sinner! If you're a worthy lean and trim sort, you'll sink swiftly to the bottom - good for you!

115:

@paws4thot: Willing to perform a blind trial to back that up? Don't underestimate peripheral awareness.

@john: I never said they weren't. His videos are full of examples of him doing it, but I don't for a second believe that it works every time. (In fact, the same could be said for almost everything he does.)

116:

@ 61:

Surely the nutritional scientists did not not really believe this, right? I mean, any idiot undergraduate students knows that the 1st Law is only useful in a closed system, and humans live on the planet Earth, not in an insulated box. Right?

I think most physicists know this already :-) Without wishing to go into further detail, reading this and related bits in the article suggests that the writer seems to be confused about some physical concepts.

117:

#115 - This guy wasn't the first or last, biggest or smallest I shared this office with, I didn't change the office layout at any time, and I'd worked with him and been aware of this for several weeks before he told me the story. Any other factors you feel a need to consider?

118:

@ 66:

At least some fraction of the health problems associated with fat are the result of prejudice. Being hated is hard on people, both emotionally and physically.

Well spoken! My daughter's mother is a very intelligent woman, well-read, talented, experienced, and generous with her time and efforts. She is also physically what my mother describes as "healthy".

And thus when patrons at our local library are directed to her as the go-to gal for some bit of arcana or other, for example, they almost invariably assume that it's the thinner person sitting next to her behind the desk that must be authority. {sarcasm}Because thin people wear the proof of their competence.{/sarcasm}[1] I'm not her, but I've seen first-hand how she's both overtly and unconsciously down-rated because of her appearance . . . and that's quite close enough, thank you very much[2]. I can only imagine what slings and arrows she suffers daily that I'll never experience.

You're damn right it takes a toll, 100% right and then some. I think the worst part that I've seen is that five-year-old kids don't seem to think anything of her appearance, but when they get to be about ten or so, they definitely start to notice. Especially the girls. Bear in mind that her bailiwick is the children's desk and the children's programs. I don't tend to think of myself as liberal, but this sort of mistreatment is one of the subjects where I go into blanket "that's not right" mode. There is absolutely no justification for this sort prejudice. It's quite hurtful, and yes, physically damaging.

[1]I'm a skinny. But she's the one who wears the pants in the family and makes most of the major decisions. We joke occasionally that I'm Spock to her Kirk.


[2]One of the few upsides of getting old is that people our age, say fifty and up, seem to have left that sort of prejudice behind along with a lot of other physical vanities. The worst offenders in this respect are the thirty-somethings, followed by the twenty-somethings. The teen set would probably be the most thoughtlessly cruel and outspoken, save for the fact that being over thirty puts people like her and me off the radar. We're not even worthy of contempt :-)

119:

@paws4thot: I'd rather see a controlled experiment than hear your anecdotes, thanks very much. That's the thing about science; it makes testable predictions.

120:

@ 67:

Actually, Calories in = Calories out is wrong, if you think of it solely in terms of human metabolism.

Like I said, it's all about where you draw the boundaries - an ur-physicist would probably place the subject in a spherical shell one meter in radius, and then measure what goes across the boundary :-)

But yeah, if you look at something like termites as completely distinct and apart from their gut ecology you'd probably get completely different notions about their metabolism and what it could handle.

Hence my little joke about physicists; what they can contribute to the discussion beyond perhaps a certain expertise in various purely physical measurements is almost completely vacuous commentary about energy flows being balanced. For questions like the one you're asking, you'd probably be better off with chemists, what with their Gibbs free energy and thermodynamic potentials and other mysterious what-nots.

121:

@ 73:

And thus we get derailed onto "Qi is real" "No it isn't" "Yes it is" discussions. Which so far to me seem to be convincingly against it being real, except insofar as humans acn convince themselves of a lot of things.

That's the beauty of the scientific method and the principles of scientific discourse. Most people I know would say (or would mean to say with the shorthand they use)that there doesn't seem to be any convincing evidence for the existence of Qi. They wouldn't as a rule flatly state that Qi is completely fictional.

Of course, along with these sorts of careful statements come certain other notions, such as burden of proof requirements. I wouldn't go so far as to say that Qi as an explanatory force is complete gibberish. But I would have to very firmly insist that the people saying it's real have the obligation of demonstrating that this is so. And there is no - absolutely none - obligation for me to try to prove the contrary assertion. None of these silly games that seem all the rage these days where I have to prove to your satisfaction that you're wrong when you posit something like Qi, and if I can't, it must be assumed to be real.

122:

@ 81:

Not wanting to hijack Charlie's thread, but I'm wondering if anyone has supplementary personal evidence for or against any of these being a factor?

Notice how even something that can supposedly be decomposed into completely reductionist statements about chemistry and physics is not exactly amenable to the physics model of experimentation?

Yet another way the 21st century will different from it's predecessor, what with the massive data-bases that will be built up and the computing power that will be at the researcher's disposal when ferreting out the sorts correlations that are amenable to causal explanations.

123:

That suggests to me that it's not willpower but a personal trainer & a personal chef that are the ingredients to losing weight.

124:

I had decades of idiot swim teachers telling me that I wasn't doing things right without even bothering to look carefully at what I was doing to try to stay afloat. I sank to the bottom of any pool the moment I stopped my frantic swimming movements. Just keeping my head a tiny bit out of the water was a minor miracle. Those cretins also told me I wasn't relaxing enough. Any human being floats naturally, those dimwits asserted. Of course I wasn't relaxing, I was close to drowning each time.

Much later I learned that yes, it is possible for genetic reasons (I was never into sports) to have a much higher proportion of muscle compared to fat, and that this was the cause of my problems in swimming pools. I also learned how to swim sideways, thanks to a lone gym teacher who finally listened and looked carefully and taught me the only practical swim technique which could keep a part of my head out of the water so I could breathe while swimming.

So, that's how I was deeply impressed by how unreliable the BMI is. It doesn't take into account genetic drift from the norm, among its many faults.

This is why I find any BMI based graph or stats map to be a lying mess of numbers.

Although, I must admit that I find the idea of fat Turks and ultra fat Saudis amusing:

http://blogweight.com/blog/obesity/dangerous-trend-obesity-statistical-maps

I'm still looking for more obesity stats world maps. I'm surrounded by epidemiologists here at work. Some of them are even specialists in the mapping of disease (both chronic and infectuous) trends. There must be something out there which is not based on the BMI.

125:

Cute? Smelled nice? Seemed commanding and dominant? Head tilted upward? Fidgety? What type of shoes did he wear? I can think of quite a few more factors if you want them.

126:

I'm trying to remember the title of the British SF Novels - by Mark Adlard ? - in which the 'Executives ' Drank the Exclusive Beer of the elite - Newcastle Brown Ale - and were also infested with bio engineered tape worms so that they could eat as much as they liked and retain their slim executive figures. Whilst I belabor my memory have a look at this ...

" You talk about the bizarre case of the woman who thought she was pregnant, but it was tapeworms. Come on. True story?

It happened in the 1930s in the Australian Outback. The woman had an enlarged abdomen and assumed she was pregnant. When it went on for more than nine months, she went to a hospital. They didn’t know what it was. They gave her a caesarean and out came this 18-pound sphere. It was a large cyst containing thousands of tapeworms. These cysts normally live in rabbits which are eaten by foxes and other carnivores. "


http://www.healthzone.ca/Health/Newsfeatures/Article/836696

127:

"EH @ 40
BOLLOCKS
Limit Beer intake to a couple of pints during the week?
What are you, some sort of mad puritan?
See my comments on my shape/diet. I take about 40 'units of alchohol' a week, sometimes more ...."

Oops - I knew that would touch a nerve. I meant a couple of pints per night on weeknights, and maybe a bit more on weekends. Two imperial pints is the equivalent of more than 3 bottles of beer. So if you hold it to 3 pints on the weekends, that's the equivalent of 26 bottles a week. Hardly puritanical. (Here's puritanical: in the US the insurance companies consider a bit over half that level (>14 drinks/week for a man) to be "problem drinking" and deny coverage or adjust rates substantially upward. Women are allotted only 7 drinks per week (!).)

Cutting back 120 oz. per week (40 to 30 units) is equivalent to cutting 1500-2000 calories per week. Switching to Amstel Light cuts the calorie intake/12 oz. unit to 95 from 150-200, so that may be a more attractive alternative.

128:

127:
Drink light beer? You monster!

129:

Following up on the gut bacteria hypothesis, here are some references:

ScienceDaily (Mar. 8, 2010) — Increased appetite and insulin resistance can be transferred from one mouse to another via intestinal bacteria...
http://www.sciencedaily.com/releases/2010/03/100304142232.htm
*

Probiotics, Prebiotics, Gut Microbiota, and Obesity by Margaret Furtado, MS, RD, LDN / Bariatric Times / November 2009
http://bariatrictimes.com/2009/11/17/probiotics-prebiotics-gut-microbiota-and-obesity/

Abstract:
This article provides an overview of probiotics and prebiotics as well as discussion on their relationship to gut microbiota and connection with current research, which suggests a correlation between particular types of gut bacteria and obesity. The role of genomics in further elucidating gut microbiota function will also be reviewed. A provocative look into the possible future applications in obesity medicine will also be provided
....
"After 30 days, subjects receiving the P. vulgaris extract with a carbohydrate-rich, 2,000-to-2,200kcal-a-day diet had significantly greater reduction of body weight (p< 0.001), with decreases in body mass index (BMI), fat mass, adipose tissue thickness, and waist/hip/thigh circumferences, while maintaining lean body mass (LBM), compared to subjects who received the placebo."
....
"Conventionally reared mice have 40-percent higher body fat content and 47-percent higher gonadal fat content than germ-free mice, even though they consumed less food than their germ-free counterparts.[14] The distal gut microbiota of normal mice was transplanted into gnotobiotic mice (a process called conventionalization). There was a 60-percent increase in body fat within two weeks, without any increase in food consumption or obvious differences in energy expenditure."

*

Gut Organisms May Influence Energy Absorption
Norra MacReady October 27, 2010 (San Diego, California)
http://www.medscape.com/viewarticle/731326

"Changes in gut microorganisms may play a role in calorie absorption in food and could influence whether someone gains or loses weight, investigators said here at Obesity 2010: The Obesity Society 28th Annual Scientific Meeting."
....
"'We were very surprised to find rapid changes in the gut microbiota upon overfeeding individuals relative to their body size, meaning that the Firmicutes and the Bacteroidetes, which comprise about 97% of the phylae in the gut microbiota, changed rapidly after only 3 days. That was a new finding that hasn't been seen before," Dr. Jumpertz said. Higher calorie absorption was associated with an increase in the presence of Firmicutes, but when calorie absorption dipped, Bacteroidetes predominated (P = .04).'"
....
"These findings suggest that individual differences in calorie or nutrient absorption may be a result of variations in gut microflora, Dr. Jumpertz said. 'I think the most important clinical finding of this study is definitely the association between changes in gut microbiota with nutrient absorption itself. This kind of implicates that a calorie might not really be a calorie for everybody.'"

130:

Ha! That was exactly my reaction today to reading Cory Doctorow's confession of a fondness for flat caps. You shouldn't be able to apply for a flat cap license until you are at least 50, I say.

But honestly Amstel Light tastes virtually like honest beer. Better than the mass-market full-calorie American "beers", at any rate.

131:

Interesting discussion.

@118: There is lots of truth to this, in my experience. In the USA (where I am), weight issues seem closely tied to status and even political alignment. I live in a pretty urban, professional, densely populated area. We don't rely upon our car on a day-to-day basis, have lots of high-quality shopping and restaurants and other entertainment in easy walking distance. We also have insane property values even after the real-estate crash (we're back down to 2006 prices, which means, it's still insane). Our food offerings are many, high quality, and often exotic. Socially, being able to cook and entertain friends is seen as a Good Thing.

So, I live in a relatively wealthy, urban, liberal ("progressive") bubble. There are few overweight people around me. When I leave and visit family out in the outer burbs or travel to the South, I'm in a much more socially and politically conservative zone with far more overweight people. I'm also in areas much more on the economic periphery. The relationship between political alignment and obesity seems pretty clear with right-wing anger over Michelle Obama's campaign. It's liberal (skinny) elites telling the rest of the country what's good for them.

Perhaps the global weight issue (among other complex factors) also involves some status issues. The stresses of modernity (plus easy access to calories, etc.) cause people to feel bad about low social status, which may kick some evolved calorie hording behaviors and physiology to kick in. It's almost a siege mentality that I see among heavier, more conservative, and more economically marginal people in America's hinter/heart land.

None of this applies to Charlie, but it's worth noting.

132:

I know you are in Scotland, dude. I was just saying that it was odd for we Americans to comment on it, considering the holiday. Syntax might have been weird, but that was my meaning.

HFCS: actually, anywhere in the EU, the food is much less sweet. I do cook for us from scratch, and we do much better than our fellow Americans. I am lucky enough to have access to many Brit formulations of Heinz foods and Cadbury chocolates, among others, because I shop at local Brit stores - had to search one out here in Georgia, but they are all over the place in Santa Monica because of all the ex-pats.

Finally, has Dude become unisex in Britain? It is in California, and I do try to write just as a writer without gender, but you missed this one!!!

133:

Simple, our alien masters are fattening us up for the harvest.

To Serve Man (The Twilight Zone)
http://en.wikipedia.org/wiki/To_Serve_Man_(The_Twilight_Zone)

Hmmm, Man, the other white meat. Cooks best with a nice honey glaze, and Grey Poupon mustard on the side.

Please include your favorite ways to serve man.

134:

Hommes frites?

135:

Try this for some spit-balling: the biochemical pathways for extracting energy and nutrients are more highly specific than thought. Until fairly recently, there weren't any intestinal critters specifically there to help digest, say, high-fructose corn syrup because even though it represents a concentrated repository of energy, it's occurrence in nature was very rare. Rare enough that supporting a resident population of the requisite helper bacteria simply wasn't worth it energetically speaking. Or maybe they didn't exist at all until some chance mutation, at which point they thrived like gangbusters in the new energy-rich environment. But how did these new bacteria come to reside in disparate groups of populations? Simple, some transgenic vector, say, an adenovirus . . .

And that's why people who are friends but never meet can acquire the new genes. You might not ever see them in person, but maybe you mail them a letter or a postcard or at any rate some sort of package that you've personally handled, perhaps after inadvertently sneezing on it. Those icosahedral packages are pretty hardy and can survive long trips in environments that would kill an unprotected human.

Once inside the new host, of course, they do their little gene swap trick and presto! The hapless host is now home to a new sort of microbe that's just dandy at breaking down highly refined carbohydrates and sugars. And if the host feeds the new breed the sort of food it likes, well, you can see what's coming.

136:

Light Beer is an oxymoron.

137:

Using "germ" in its broadest sense, both bacteria and virus, you all may find the following interesting. It relates to a completely different part of the body:

http://discovermagazine.com/2010/jun/03-the-insanity-virus

With thanks to Paul Raven over at http://futurismic.com/.

138:

It's liberal (skinny) elites telling the rest of the country what's good for them.

This is the What's The Matter With Kansas fallacy. It goes a little something like this: The left half of the political spectrum, after doing very well on economic causes up to the late 70s, hasn't done so since. It has done rather well on identity causes, though (a lot of which are directly economic, a problem this worldview doesn't tackle). Therefore, the reason why self-identified Republicans are such is the cultural/identity issues.

Conclusion: throw the blacks and women and gays and immigrants under the bus, forget you've broken the atmosphere and bridges are falling down, and hope the Republicans give you your reward in heaven.

Shorter conclusion: capitulate faster, please.

How this plan is working out in reality is left for empirical observation. I for one suspect this has been integrated into the Obama codebase without documenting it.

139:

All our ancestors managed to save sufficient surplus when there was food around to survive the periods when there was not, for long enough to reproduce.

Now things have changed, and it has been summer for a long time.

So it goes.

140:

Chlamydia would be the infectious obesity of preference if you want it cured. The NHS would be happy to test you and with a round of antibiotics you are cured.

http://www.gghjournal.com/volume20/3/obesity.cfm

Amantadine seems to be the lesser evil as an antiviral for adenovirus.

141:

Last January, I challenged myself to do something difficult but not impossible. I chose to go a month without alcohol. I like my beer, a lot, but I didn't think I was addicted so I felt it fit the bill.

Within a week, I'd worked out that the non-alcoholic options in pubs were mostly dire, and for the rest of the month the alcohol was mostly replaced with water. That I worked this out so quickly should indicate how much time I spend in the pub.

Nothing else about my lifestyle was changed. I kept up the exercise, ate the same etc. I estimate over that month, I reduced my calories by 15%, possibly a bit more if I was lying to myself about how much I drink. Given that I eat mostly vegetables, and not a lot else apart from tofu, I was eating at a level which ought to lead to significant weight loss.

It had absolutely no effect on my weight whatsoever. Nor anything else for that matter. And the whole challenge turned out to be easy in the end. Will have to think of something harder next year.

142:

"Please include your favorite ways to serve man."

I love children - nothing else goes so well with a shallot-reduction based plum sauce.

143:

Thanks for replying. If reducing your beer doesn't do anything, by all means drink up and enjoy yourself! I'd cast a wary eye on that infernal tofu, though. Chock full of phytoestrogens it is. I prefer salmon and tuna (despite the mercury) and supposedly the fats are healthier than most.

144:

http://www.economist.com/node/17572242?story_id=17572242&fsrc=rss cites teh same research.

It's genuinely weird, but my hunch is that the research won't hold up. Radical claims require radical evidence. We'll know in a few years.

Still, I do admit viruses are way, way, weirder than we ever imagined. Carl Zimmer (Loom) has had some great articles lately.

BTW, the non-science part of herbalism was the implicit (sometimes explicit) belief that herbal remedies had a much higher benefit/risk than manufactured drugs, so they didn't need the same testing for efficacy and harm. Like, for example, nicotine.

145:

You might be right...but then again, income inequality isn't the same thing as poverty. Those problems which are more correlated with income inequality may not be caused by material deprivation, exactly...

The authors of "The Spirit Level" - public health specialists who've run a lot of statistics - suggest that it may have to do with the social and psychological effects of steep social hierarchies and harsh pecking orders in everyday life. Also lower levels of trust in highly unequal societies.

146:

If it really is AD36 you can bet your ass a shitload of fat people will no longer be able to hug their kids because they'll be afraid of contamination
It'll be like AIDS all over again but with fat people

147:

I'm required to get at least 1000 calories a day (and just about exactly 50gr protein per day) and by the end of the day, I have to eat more to get to the minimum. I spend more calories than that in walking, household work, and (I laughed when you had this) jiggling feet. Heck, a nap takes 36 calories every half hour. So, theoretically, I should lose weight. I don't.

None of the things wrong with me have anything to do with my weight, which I gained during two long hospitalizations where I had N-G tubes deliver "food." The stroke last year had the same thing happen -- 26 days in the hospital with the first seven on IVs and the later 19 on regular hospital meals and I gained 25 pounds. (As it happened, I had to have cytoxan which has a side effect of losing weight and I've lost 48 pounds in a year and a half. I've been here for three months, so I think this is it.)

148:

I was able to walk the last 2/3rds of the first renal failure (had a stroke in the beginning of the renal failure and had to learn to walk, read, and take care of myself again) and at the very end of the second renal failure (the first nephrologist didn't diagnose the disease and my feet were like loaves of bread and my fingers like sausages -- you're not allowed to walk on that kind of feet). I also did PT and water exercise for many years without losing weight. Even with "chronic renal failure," my glucose is about 80-85, so no diabetes.

I even had a doctor put me in the hospital for two weeks some years back and made sure the nutritionist and nurses made sure I only had 1000 calories a day along with water exercise every day (water exercise takes more calories than the same exercises in air) and I didn't lose weight.

149:

I used to have cold rooms, but it looks like I'm heading into Raynaud's so I have to keep the condo warmer until I go to bed. I can't stand up long enough to cook (and can't afford to buy a house with an adapted kitchen), I eat small amounts (have trouble getting 1000 calories a day), and don't particularly like sweet things. I'm very obese.

150:

Do you know how brown sugar is made? White sugar with molasses added. It does have a different taste, but it's still just sugar.

151:

LOL I was amazingly skinny as a kid, this is 16 years old and 115 pounds, and I made that dress. But I couldn't stay under water for very long and couldn't pass the last YMCA swimming test because I had to keep pushing toward the bottom of the pool to stay under to the other side and it took too long.

When I was 15-17, we had a pool outside and I could just relax and sleep on it until my brother got home from school and started cannonballing.

152:

I don't recall just where it came from though I'm pretty sure the article was linked to from Making Light, comment or sidelight. The history of BMI is pretty arbitrary.

Step 1: A Belgian, over 150 years ago, produced a pamphlet based on his personal opinion of who was "well proportioned" which listed a few combinations of height and weight, and whether they were over or under his ideal.

Step 2: This pamphlet seems to have been the primary source, a century later, for height/weight tables used in the USA.

[I'm inclined to doubt it was the only source: it's too big a jump. The insurance industry had an obvious interest in teasing out correlations. Obesity is something which loses them money. Unlike tobacco and the tobacco industry, which benefited from hiding the evidence. And maybe these tables are what triggered the minimal-evidence diagnosis of obesity.]

Step 3: These tables were used to calculate the BMI system.

Step 4: Doctors are taught a neat formula, and forget to look for other indicators.

So the ideal weight your Doctor is pushing on you is based on what a 19th Century Belgian thought looked hot.

Maybe.

153:

I wonder if this trend isn't something much simpler: the decline in smoking. French are still thin because they have a lot of nicotine fiends. Americans cut way way back on cigarettes and ballooned up.

154:

O RLY?

Have you visited Paris recently? They've banned indoor smoking ...

More to the point, if there was a nicotine/obesity inverse correlation, you'd expect average girth to have decreased during the boom years in smoking (approximately 1870-1980; remember, smoking didn't become ubiquitous until the mass-produced cigarette came along, which happened surprisingly late).

155:

The soya thing is entirely Scaremongering from the dairy industry, whose own products are so full of hormones that the irony is ridiculous. No actual genuine research has found any risk to humans whatsoever.

The fish oil thing is also falling apart quite dramatically now that other researchers are trying to replicate the results. Ben Goldacre covers it regularly in his Bad Science column.

156:

There are different sorts of brown sugar. Many are as you describe, but others are genuinely less refined forms of sugar and, in the UK at least, the names are protected so you know what you are getting.

157:

Whilst its true that when you quit smoking you will tend to put on some weight I doubt very much that that explains the girth of some people. It is just a simple matter of them eating too much and moving too little. I have this problem myself in fact.

I used to work as a conductor on the railways in the UK. Which was great because I was constantly on the move checking tickets and running back to open the doors at the next station. Kept me fit as a flea and weighing in at about 9 and a half stone. Then I got a drivers job... Oh dear. I now weigh in at 12 stone, And simply for the reason that I now spend 10 hours a day sitting on my ass looking out of a window. I dont eat any more or less than I used to, I did quit smoking but that has made little difference as I did that 7 years ago when I already weighed 12 stone.

So In my own case it really should equate to eat less, move more. Or make sure that calories in is less than calories out.

158:

#various ref Qi - My original statement was that I'd met one otherwise unexceptional individual (not big, not small, not arrogant or particularly assertive, not noisy, not quiet, not fidgetty etc for as long as you can thing of parameters) who still had something unusual about their presence, which made me think that there could be something in the concept which meritted further investigation.

Charlie, please treat anyone who makes a further statement that suggests to you that "they can't/won't accept this as a proposal" as trolling.

159:

The hormones thing is entirely Scaremongering from the organic foods industry, whose own products are so full of diseases and pests that the irony is ridiculous. No actual genuine research has found any risk to humans whatsoever.

160:

Query from my grandfather, a production chemist - "Why do we pay more for Demerara sugar, when it's easier to make, because they don't refine the molases out of it?"

161:

You might want to spend a millisecond working out why I prefer what I do before snarking. Otherwise it just looks like Roger Irrelevant has dropped in.

162:

Distribution costs - they don't have the economies of scale of fully refined sugar.

Next!

163:

@ 127/8
BEER
My local sells TT "Landlord" (My usual first 2 pints), "Tribute", Nethergate Ruby Mild, Adnams, and also (hic) bottled De Konick Blond.
I take your point about per night .....
The US perversion on "beer is evil" is really weird.
Depends on what you mean by "light" beer.
There is a brewpub, though they've just upped production in a new unit, just down the road from their main outlet, called "The Union" (outlet for Meantime beers) in Greenwich. They do ales, and continental-style pure (Rheinheitsgebot) beers. Their Kölsch is wonderful stuuf. Really, really pale, 4.5% (IIRC) and very drinkable.

@ 137
Scary
Physical events have physical causes.
Now try convincing a psychiatrist of that.

Feorag @ 141
You aren't going to like this, and I will have to buy you a beer next week if you really insist (to make up) ...
But how about eating animal products, like eggs and milk?
Eggs can be sourced from free-range farms, no problem, and goats' can't be factory-farmed, so their milk is OK (I drink almost only goat-milk anyway).
Humans evolved to be omnivores, after all - one of the reasons for our success, I think.
also @ 155
Again, another reason to drink Goat's milk and avoid mass-dairy from factories.
also @ 156
"Demerara", for instance?

@ 152
Yes.
And the statistics-gathering for a "real" BMI index (IIRC) was done in the dustbowl states of the USA, during that period.
Oops.

@ 159
Depends on which country you are in.
In the USA, cattle are fed up with all sorts of stuff that isn't allowed here, like antibiotics (thus making sure we have more resistant bacteria) and some hormones.
It varies, so your statement is a little sweeping, to say the least.
I do hope you are not implying that my home-grown vegetables are "full of diseases and pests", because you'd be wrong.

164:

That is the point, Robert. If zoo-oestrogen in milk does no detectable harm in people why would you expect the much less active phyto-oestrogens to cause harm?

Those three aphids I ate last year really made me ill, /sarcasm.

EH @ 143 The WHO recommends not eating fish that have high levels of mercury and another UN organisation recommends not eating fish because it will lead to the death of the oceans as we know them by 2050. Both seem like good reasons to me, I value my brain and like to swim in the sea occasionally without being molested by giant squid.

165:

paws4thot @ 160 Sugar refiners can also sell the molasses separately for a good price if they produce white sugar from cane or beet. The handling problems of sticky muscovado sugar means more expensive techniques are necessary than with free-flowing powders.

Greg @ 163 How about not eating eggs and milk because it is a disgusting idea? Chicken menses and ungulate baby food. Chickens may be one of the most efficient transformers of real food into meat but don't you think it is a bit icky?

If your goat milk does not contain oestrogen might I suggest your suppliers should learn the difference between a billy and a nanny?

Humans evolved eating whatever crap they could scavenge, how much mollusc, insect and arachnid do you include in your diet? Science is a wonderful thing, all I need is fortified margarine and I am a completely healthy vegan.

166:

#162 and 165 - [whoosh]

167:

http://dspace.dial.pipex.com/l.j.hurst/adlard.htm

(There's also an article on Wonkypedia about him.)

169:

brown sugar is white sugar before they take the molasses etc out I thought.
some sort of activated charcoal process


what is that american beer phobia about? are there, perhaps , some similarities between them and the taliban?

170:

#169 - That's true of Demerara (qv) and I think Muscavado, but I'm less sure about "soft brown".

As for the American "beer phobia", I think it's more of an "alcohol phobia". Have a look at the 18th Amendment to their Constitution http://en.wikipedia.org/wiki/Amendments_to_the_United_States_Constitution

171:

>what is that american beer phobia about?

Are you referring to the definition of 'problem drinking' mentioned upthread? While americans do seem to be puritanical about drink, those are the same recommended safe drinking limits (14 units/w for men, 7 for women) used in the UK.

Drinking more than that on a regular basis is considered likely to result in some damage to your health. It doesn't mean you are an alcoholic.

172:

Nobody wants to talk about the change in the definition of overweight in 1998 - changes in how BMI is interpreted - that suddenly created 25 million more customers for diet pills in the US alone.

Saying more people are overweight is not the same as saying people weigh more.

173:

@ 147:

I'm required to get at least 1000 calories a day (and just about exactly 50gr protein per day) and by the end of the day, I have to eat more to get to the minimum. I spend more calories than that in walking, household work, and (I laughed when you had this) jiggling feet. Heck, a nap takes 36 calories every half hour. So, theoretically, I should lose weight. I don't.

I didn't mean that to be the culprit or even a significant one; just an example to show the vacuity of the statement "calories in minus calories out equals net weight gain". The statement is true, it has to be. But with something this complex, it's not a particularly revealing one.

Hmmm . . . try this as an analogy from my days on the farm: the amount of wood coming in the front and side doors minus the heat generated and the ash and other remnants going out the back door or up the chimney equals the amount of wood inside.

A true statement, obviously. But all wood burned is not equal; seasoned hardwood lasts a lot longer than fresh-cut pine. Wood burned in the fireplace is nice, but it's not nearly as efficient as wood burned in a Franklin stove. And of course, more wood is burned in zero-degree weather (Fahrenheit for us Yanks) than is burned in forty-degree weather.

So why does that idiot boy keep bringing in firewood even though the weather is fine and there is plenty of wood inside anyway? Doesn't he know there's a new stove? Or that it's burning oak and not pine? Or that it's a sunny 50 degrees outside? You can turn this around and also ask why it's so cold inside even though you've got three or four fires going . . . which again could have several causes.

174:

The UK numbers I've seen are 21 for men and 14 for women per week. And even that is a reduction from the 28/21 that I saw on a leaflet handed out at my GP surgery fifteen years or so back.

175:

You are right. Not sure what I was thinking.

176:

@ 141:

Within a week, I'd worked out that the non-alcoholic options in pubs were mostly dire, and for the rest of the month the alcohol was mostly replaced with water. That I worked this out so quickly should indicate how much time I spend in the pub.


Nothing else about my lifestyle was changed. I kept up the exercise, ate the same etc. I estimate over that month, I reduced my calories by 15%, possibly a bit more if I was lying to myself about how much I drink.

This is an idiot question, something I'm sure you've already accounted for, but I'm just checking: you aren't drinking any soda or juice at the pub or elsewhere are you? And presumably your activity levels are just as high? I don't drink very much but when I do, I um, tend to become more active, that is to say, boisterous.

Also, I totally buy into that high-fructose high-calorie soda/juice factoid. I know people who have have gone from coffee to Coke for their stimulating beverage of choice (in an ill-advised austerity measure, the department has stopped supplying coffee - and even hot water - gratis. This has been worse for morale than the department getting really stingy with it's graders, imho) and their weight gain has in several cases been quite noticeable since that cataclysmic event.

177:

My last primary had me take fish oil for my cholesterol and I went from way too high to well in the normal range. (Not what you meant, but it's good for something!) I get the kind that has you burp because I'm still home when that happens and Spirit is on my lap and loves to smell the burp. She also likes to lick the tuna can.

178:

This is an idiot question, something I'm sure you've already accounted for, but I'm just checking: you aren't drinking any soda or juice at the pub or elsewhere are you?

I can state with certainty that during her no-beer month, Feorag was drinking carbonated water, not soft drinks. Also, her activity level was normal.

179:

I'll throw out two issues that really need to be included in ALL research on acupuncture and acupressure. Most western tests of acupuncture would fail one or both of these.

1. It works on animals. This isn't news, and there are traditional acupuncture points for things like horses and elephants. I can't cite articles, but I know that acupuncture has been tested by modern veterinarians too.

This definitely eliminates any placebo effect, as I don't think an animal has expectations that those needles will offer pain relief.

2. Personal anecdote: A family member had encephalitis that required removal of part of his brain in order to save his life. The operation left him epileptic and unable to feel the right side of his body (that part of his brain had been removed). He and his wife discovered, totally by accident, that if they held his right big toe hard at the onset of a seizure, the seizure subsided. Decades later, they found out that a pressure point on the big toe acts to calm seizures.

To me, this isn't proof that all of acupuncture's claims are real, but it does eliminate a LOT of potential explanations for the practice. For example: it's not just about pain relief, the patient doesn't have to feel the pressure or needle to get the effect, and if acupuncture is brain-based, it is not mediated by the top layer of the brain associated with things like body perception, because it works without that brain tissue even being present.

Moreover, it's a good example of how acupuncture points probably were discovered: the hard way, by people desperate to help others, and quite possibly by accident.

180:

>1. It works on animals. This isn't news, and there are traditional acupuncture points for things like horses and elephants. I can't cite articles, but I know that acupuncture has been tested by modern veterinarians too.

Unless the trials are properly controlled you can't rule out (unconscious) bias in those conducting the tests.

>This definitely eliminates any placebo effect, as I don't think an animal has expectations that those needles will offer pain relief.

Not really. The placebo effect is documented in animals, at least some of which seems to be down to an effect on the owners.

181:

if you don't like the fact that the usual 'brown' sugar isn't healthier than refined sugar, use whole cane sugar/jaggery (does taste different to refined and brown sugar but not that much) - one study">http://adr.sagepub.com/cgi/reprint/9/2/152">study suggests it may even prevent (or help prevent) dental caries

182:

@ 178:

This is an idiot question, something I'm sure you've already accounted for, but I'm just checking: you aren't drinking any soda or juice at the pub or elsewhere are you?


I can state with certainty that during her no-beer month, Feorag was drinking carbonated water, not soft drinks. Also, her activity level was normal.

I guess you'd be the one to know :-) The discussion is complicated by it's heterogeneity. I'm making a rough guess that of the people who aren't at their desired weight or who aren't gaining or losing weight the way they should, 68% are accounted for by very simple observations of calories in/calories out, another 27% are due to some odd behavioural quirk they aren't accounting for (the "I didn't know soda was so fattening" sort of thing), and that maybe 4.7% have some sort of metabolic oddity.

May I ask another personal question? Pardon me for saying this, but I've seen your picture and footage from various con panels and you don't seem to be particularly overweight. In fact you're probably thinner maybe half my relatives in the over-forty set. So my question is, are you particularly concerned because of what some weight tables say and their (possible) health implications, or because you feel somehow "wrong" on the inside? That something is "not right", based upon your mobility and activity levels? Because if not, if you don't have any weight-related health issues, and in particular, the old noggin's in good shape (which is 95% of the reason I do any exercise), then I'd say you've got nothing to worry about.

Iow and more generally speaking, assume that there is some sort of generalized weight gain in the population. Is it necessarily harmful? If not, then it's a nice question to speculate about but there isn't any particular urgency or gravity to it.

This is yet another 21st century type question, i.e., really only amenable with access to large data-bases and the computing power to effectively sift through them. We'll be seeing a lot more of those as data collection becomes more ubiquitous and people become more blase about it.

183:

OK, there's a few things there, but...

Antibiotics in animal feed: they are very different in how they work from the antibiotics used in medicine. Resistance to those antibiotics doesn't affect medical use. They're used to modify the mix of bacteria in a cow's stomach so as to increase digestive efficiency.

It's a closely regulated use.

I'm afraid you've fallen for one of the lies of the organic movement. Here in the UK the Soil Association, which sets the rules, also seems to be against effective preventative veterinary medicine.

Is there a another reason to be against the use of these antibiotics: I don't know. But since they seem to push a lie as a reason, I'm inclined to doubt it.


184:

damn, need to learn to use the preview button - the link should be study

185:

Who's been lying to YOU? The US National Academy of Sciences, US Centers for Disease Control, and World Health Organization have all called for less livestock antibiotic use. 10 minutes with Google Scholar or PubMed makes it abundantly clear that organic food promoters aren't the only people with concerns about antibiotic use in healthy livestock.

186:

I say we blame high fructose corn syrup and be done with it.

187:

Nice idea. Alas, doesn't hold up outside the USA (where HFCS production is subsidized) -- for example, it's virtually unheard-of as an additive here in the UK, but we still have the obesity epidemic.

188:

Interesting point about placebo effect in dogs. It also speaks to a central problem, which is that if you massage a point and things get better, AND that point turns out to be an acupuncture point, was that due to the placebo effect calming the owner or the owner accidentally treating the dog?

The better question is whether someone can, through using observational trials of recovery from illness, find the acupuncture points that treat a condition? That's what my relatives did, and it's certainly possible.

Finally, while I can't speak to whether the trials were properly conducted, Googling on "animal acupuncture study," going to acupuncture.com article on dogs suggests that acupuncture can be used to treat many problems in dogs. Quite honestly, If I could figure out how to use a placebo effect to treat these problems in humans (and our pets), I would be extremely happy, because I and people I know and love suffer from them. Such a simple cure would be great.

Data dump follows. Feel free to chase it down, as I don't have access to these articles:"Favorable acupuncture results have been reported in the treatment of many other canine conditions, including the following: cardiovascular disorders (9), chronic respiratory conditions (10), dermatological disorders (11), gastrointestinal disorders (12), gynecological disorders (13), immune-mediated disorders (14), male reproductive disorders (15), musculoskeletal disorders (16), neurological disorders (17), reproductive disorders (18), thoracolumbar and cervical disc disease (19, 20).

9. F.W. Smith Jr., "Acupuncture for Cardiovascular Disorders," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 125-131.
10. C. Schwartz, "Chronic Respiratory Conditions and Acupuncture Therapy," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 136-143.
11. K.C. Waters, "Acupuncture for Dermatologic Disorders," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 194-199.
12. S.G. Dill, "Acupuncture for Gastrointestinal Disorders," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 144-154.
13. J.H. Lin and R. Panzer, "Acupuncture for Reproductive Disorders," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 155-161.
14. P.A. Rogers, A.M. Shoen, and J. Limehouse, "Acupuncture for Immune-Mediated Disorders: Literature Review and Clinical Applications," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 162-193.
15. Lin and Panzer.
16. A.M. Schoen, "Acupuncture for Musculoskeletal Disorders," in A.M. Schoen (ed.), Veterinary Acupuncture: Ancient Art of Modern Medicine," Mosby, St. Louis, 1994, pp. 159-170.
17. R. Joseph, "Neurologic Evaluation and its Relation to Acupuncture: Acupuncture for Neurologic Disorders," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 98-106.
18. Lin and Panzer.
19. L.A. Janssens, "Acupuncture for the Treatment of Thoracolumbar and Cervical Disc Disease in the Dog," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 107-116.
20. T.E. Durkes, "Gold Bead Implants," Problems in Veterinary Medicine, Vol. 4, No. 1, March 1992, pp. 207-211."

189:

Placebo effect is often confounded with mood or intention affecting illness outcome. As Charlie said upthread the placebo effect is merely the natural percentage of recovery from the disease or condition without any interference. It is the action of the body healing itself.

Thinking positively has been shown to add a small improvement beyond placebo in some studies. However, animals do not have to feel the vibes or recognise a white coat to benefit from placebo. Or suffer from nocebo.

190:

Thanks, Charlie, for mentioning that herbalism is real medicine, if insufficiently tested for many remedies. Being a pharmacist it would be difficult to ignore that, I suppose. The confusion with voodoo placebomantics annoys me as economic botany is my hobby.

191:

case of clever HAns,,, 'wow, the horse can do maths!!'

192:

Back on the original theme, here's Der Spiegel on the subject of a Texan woman with an odd problem -- emaciation and a BMI of 10.9 despite an intake of 8000 calories a day.

193:

Re "we have more food available now"

I have read a gastronomy training cookbook from the 1920ies that my grandfather owned; it doesn't list recipes (you were supposed to know how to make a pork roast etc at that point) but how much to buy if you expected to make 100 lunches, or 200, and how to size portions. The latter is the relevant part here:
What was a simple, -modest- lunch for people on a budget is more than I eat in three days. A lunch for the better-off people would easily feed me a week (five course, soup, fish, chicken, pork, salad, veggies and potato/dumpling sides, dessert).
Those were not for feasts, but what you sold as lunch Monday through Friday.

This assumption that people used to eat less (outside of famine situations) is IMO patently wrong. They ate more, a lot more, and also a lot more fatty than I could eat without gagging.
Of course they also worked physically a lot more than we do today, and not just an hour of exercise but 8-10 hours a day.

194:

In re qi: given the description of the fellow asked to leave the room, it ought to be easy to test for. Get a mix of (supposed) high-qi and low-qi individuals, and a mix of folks sensitive or not sensitive to it. Separate them by an opaque screen and pair them up, one per side. Given the description above, there should be a significant difference between individuals in both groups, and it should be repeatable.

195:

On AD36 and obesity:

Even if a correlation is found, it doesn't mean one causes the other. In fact, it could be quite the opposite from what's being noised about: the virus might be better-suited to live in fat cells, thus making the obese more likely to be infected by the virus.

196:

I don't doubt there's a multitude of factors. For myself, I went from 55 kilos at 182 cm when I married to 65 in two months of constant and mandatory overwork at my new job with a choice of Chinese takeout or macdonalds every night.

Then everything was stable for some time, until I started getting chronic bronchitis which apparently doctors are not allowed to treat with anything but prednisone. Every week of prednisone is one kilo extra for me, and that never leaves me.

One week in South-India and eating local food and I feel like I have more energy than ever before. On the other hand, returning from one week in Ireland and I needed to move a couple of holes in my belt, but that went back to normal in a week as well.

197:

@ 193
... and most of their houses were COLDER and DAMPER.
They needed more food, just to stay stable - they literally "Burnt it off".

198:

8000 calories a day...
(wrong author, but:) fatkins' hummingbird-metabolism-gene?

199:

Or the bumblebee futile cycle?

200:

Back in the 20s cookbooks were for rich people, the 5% of families or so who could afford a kitchen servant if perhaps not a service-trained cook. Poor people ate simple foods a lot and there are only so many ways you can cook a potato, no reference works required.

Today, food is *cheap*, so cheap and so readily available that the organic food business was invented to make some forms of cheap food expensive.

201:

i have a nasty , knackering physical job
not buying that one sorry#

202:

I was off for 5 weeks this yeatr,, hand smashed by work syndrome
I got fatter
portion control Im a thinking

203:

There is a reasonable history of diseases that were thought to be due to "moral failings" of the person with the disease or someone near them (usually the mother, of course). Autism was blamed on mothers who failed to bond with their children, schizophrenia was blamed on "cold" mothers, AIDS on various drugs used by gay men, stomach ulcers on being a "Type A" personality, and so on.

It would not surprise me at all if obesity is caused by something (AD36 or otherwise) purely disease-related.

There is no question in my mind that the hysteria about obesity (whose rates have in fact leveled off in the US in the last few years) is more about class than about health.

204:

I don't use sugar. I don't even have any in the condo.

205:

RE the use of antibiotics in raising livestock: at least in the case of chickens experimentation has shown that massive use of antibiotics isn't necessary to keep the animals healthy as long as proper cleanliness is observed. The reason for not wanting to use antibiotics unless necessary is of course that we've been overusing them for some time, and reaped the drug-resistant whirlwind. It's amazing just how paranoid about germs like MRSA doctors, nurses, and hospital administrators have gotten in the last few years. I got the full treatment of questions about exposure to skin infections, etc., from them before my last surgery a few weeks ago, and that was in a small hospital in a middle-class satellite town, not for instance an urban teaching hospital.

206:

@ 200
Codswallop
"Organic" food has been around (here) for many years.
It has become more popular, because of the huge amounts of additives put into and onto much food.
Try reading "Silent Spring".

@ 203
Yes.
Physical events have physical causes.

207:

Drat. There goes one of my points of belief. Oh well. Time to start learning again.

208:

I know the organic movement has been around for quite some time and I know of the increasing popularity of organic food in shops. Its rise to prominence is based on scaremongering and misinformation like many fads and religions coupled with the increased spending power of consumers which makes the price premium for organic (and fairtrade too) affordable.

Imagine that regular factory-farmed disease-free carrots, grown with the aid of chemical fertilisers and dosed with effective pesticides cost 10 quid a kilo and their pest-ridden organic equivalents, grown with the use of factory-farm manure and dosed with ineffective but still toxic "organic" pesticides cost thirty quid a kilo. Would you buy the organic carrots or would you bite the bullet and get the cheaper factory-farmed carrots which are as just as safe to eat and as nutritious as the Soil Association-approved carrots and not pay extra for the feelgood woo-woo?

That's it basically. Industrial farming methods and the farm-to-shop logistics revolution has made food really really cheap to the point where spending more money for emotional reasons doesn't hurt folks in the pocket quite as much as it used to and so they have provided the organic food growers with a ready market for their overpriced produce.

Processed foods are another matter but a rational comparison of organic and factory-farmed produce side by side reveals there is no practical difference apart from the pricetag and the feel-good.

209:

I apologize if this comment is too long - I find this topic fascinating. I've been noticing the health/morality trend for a while now. It manifests itself in many, many different ways. I read a NYT article once about couples whose relationships are strained because the partners had widely divergent eating habits. One might be a vegetarian, the other a committed carnivore. One wants to spend more money on organic food, the other would rather save the money and buy conventionally grown produce. Etc.

It reminded me strongly of how some religious groups are defined in part by certain eating habits - kosher, halaal, that sort of thing. Some of us may not be used to the idea of eating as a moral act, but it's a pretty old idea. Personally, I'm glad that these days, the debate centers around human and environmental well-being rather than Teh Will of God.

However, it is certainly true that responsibility is laid too heavily on the backs of individuals, rather than on corporations and policymakers.

Take for example the policing of pregnant women and mothers. If you're fat, your baby will be fat. If you don't eat the right foods during pregnancy, your baby will be a picky eater, or perhaps lag behind its peers by 2.63 IQ points. If you use disposable diapers, you're a bad mother and you hate polar bears. And you absolutely MUST breastfeed.

And I do think that women should be of normal weight to begin with, eat well during pregnancy, breastfeed, and use cloth diapers. But the reality is that, at least in the US, there isn't enough social support for childrearing to allow people to do all that. Mothers (and fathers too) can only do so much without risking their ability to earn an income. The lower you get on the income scale, the more compromises you have to make, so poorer people are inevitably the least moral. This allows richer people to feel superior, but, of course, tends to reinforce the status quo rather than generate solutions.

On the subject of weight loss specifically, I completely agree that calories in vs. calories out is naive and simplistic. Calories aren't used for just one thing. They can go into generating new fat cells and new fat, raise your body temperature, build muscle, and probably many other things besides fuel activity. Plus, there is the issue of hunger. Some foods are much more satiating than others. The source of calories matters at least as much as the amount of calories. And then there are issues like sleep quality, stress, and lifestyle. Sometimes there are unknown food allergies to deal with. Gut bacteria are fascinating, and it sounds like they have a big influence as well.

When I finally lost weight, it was due to a combination of things. Calorie-counting was part of it. I did the calculations and figured out that if I wanted to lose a couple of pounds per week, I should consume 1000 calories per day. But I knew that wasn't enough food, so I instead ate around 1400-1500 calories per day and worked off 400+ calories every day on the elliptical machine, which only takes 35 minutes.

That worked well, and I lost 18 lbs that way, but it was slower than I'd have predicted. It wouldn't have worked at all if I hadn't already weaned myself off of fruit juice and other sugary things that make me feel like I'm starving, and if I hadn't taught myself to distinguish between hunger and thirst, and if I hadn't learned that I needed to eat a handful of peanuts at around 10 am to keep me sated until lunch, and if I hadn't known that having too much food at my desk makes me eat too much. Also, I wasn't overly stressed, I had a regular work schedule, and I got plenty of sleep.

But that's just me. My main issue was appetite control and sugar addiction, and I think that's pretty common, but it doesn't work the same way for everyone. I have a very good friend who historically has eaten much better than I have and is more active, but is much fatter than I am. Basically, there are just a ton of things that influence weight, and they are highly personalized.

210:

@ 208:

Imagine that regular factory-farmed disease-free carrots, grown with the aid of chemical fertilisers and dosed with effective pesticides cost 10 quid a kilo and their pest-ridden organic equivalents, grown with the use of factory-farm manure and dosed with ineffective but still toxic "organic" pesticides cost thirty quid a kilo.

That's odd; I grow organic now and I've never had those problems. The worst pests I've had over the years have been the dogs who for some reason like to tear up the tomatoes.

This was also true for our quarter-acre truck garden growing up. I'll complain - a lot - about the endless hours of drudge labor planting, maintaining, picking, and canning, and the subsequent monotony of overgrown green beans three nights a week. But we never had "disease-ridden" produce and we never sprayed for anything that I can recall.

Back on topic - growing up, our trips to the store were for things like flour, salt, sugar, coffee, not frozen pizzas (That's probably why I have no taste for any sort of soda today - we only had it as a rare treat.) All of us kids also had jobs, which weren't trivial given that we had no electricity or running water. And while none of us were out-and-out fatties, we still had quite distinctive body types which didn't seem to correlate with the amount of work or what was eaten - from the ages of about 3 to 11 my one-year-younger sister outweighed me for example. Even now I play ecto to her endo and to this day I can't sit still for more than 90 minutes while she can remain comfortably immobile for literally hours. She's also paid better than I am and I think that might have something to do with it :-)

In any event, it's no stretch at all to believe that metabolism can be altered by any of a number of environmental factors. Or to believe that various formulations of calories in/calories out are essentially vacuous statements for this sort of thing.

211:

@ 198:

8000 calories a day... (wrong author, but:) fatkins' hummingbird-metabolism-gene?

I've been googling for a story about a guy who had to pull a fifty-kilo sled every day to a weather station six miles away who burned a tremendous amount of calories but I can't find it. Here's something similar though:

A pound of bacon at breakfast -- yum. An entire strawberry shortcake a day -- not hard to take, if you like sweets. It's harder to find that many calories on expeditions: My peanut butter sandwiches are 1,000 calories each, but I can rarely get through an entire one in a day, unless the day is long. A pound of milk chocolate is about 2,000 calories; on cold trips, I used to eat a pound a day; less now. I suspect that I've never eaten more than 6,000 calories per day on sledding expeditions, even though I eat a lot compared to my partners. On spring (April-May) sledding trips, which are warmer, I estimate I eat 4,500-5,500 calories/day, depending on how hard the trip is.

The story I recall had the guy consuming around 8,000 calories, a lot of them very fatty. He also made the observation that his fat cravings were intense while on the job but that once he moved south into warmer weather they pretty much disappeared. I'm guessing that this is something built in to the human body, sort of like the diving reflex.

Possibly these metabolic pathways can be tricked and tweaked with the right biochemical cues to either lose weight while consuming 6,000 plus calories a day or gain weight on less than 1,000. It's also possible that things like adenoviruses can mess with those cues, rather than outright destroying a complex chain of metabolic processes without killing the victim in the process.

212:

My brother stuttered madly as soon as he could talk -- sometimes a minute or two with the partial word -- and he had to see psychiatrists every time we were transferred. He took Spanish one summer (our mother was a teacher and always took a class the first part of the summer, so my brother and I did, too) and it turned out that he doesn't stutter in foreign languages.

Then a few years back, he tripped on a slate stepping stone on the way up to their door and hit his head on another stepping stone. He now has a metal plate there (and a letter to take with him when he flies) and doesn't stutter anymore. It was a condition of his brain all along.

(Turned out that he damaged his left temporal, which is the same place both of my strokes were.)

213:

I don't know where you have seen organic produce but the stuff I buy is cheaper and better quality than the non-organic in the supermarkets, except in midwinter for summer veg. Very few visible pests.

214:
"As someone who both loves and reads Mr. Stross' work and is paid to train people to look, feel and perform better, please take it from me that to tell a client to 'eat moderately, work out regularly, and exercise your willpower!' means I would be out on the street starving because it quite simply does not and will not work."

Err, sadly, no; there are certain cognitive biases etc. at work, so sadly, it's not that easy. But that's not only with execise, but with every medical intervention; though in the case of exercise, how can you test this with double-blind placebo?

Problem is, even if our weight is more or less stable, there are some fluctuations; if you gain weight, you are going to drop from the exercise course, if you're stable, you're likely to stay on it, if you lose weight, you may endorse the program wholly. Second of, if there are different subgroups that respond different to exercise. and there is a subgroups that responds to execise, they are more likely to stay in the program, if they don't, they are likely to drop, adding to the impression that they could loose weight if they stayed in the program. Then, we don't know what happens if they stop the exercise course; if they stay slim, you won't see them again, if they gain weight, you get the impression that exercising gets you slim and stopping exercise gets you fat; oh, and it starts all again then. So in a way, even though I believe that exercise and caloric restriction are a way to loose weight, in my opinion there is an annoying dearth of data on this. But then, any induction from a sample size of 1 (I lost weight through rigorous exercise / I can eat whatever I like and get no fat, so can you) is scientifically dubious. Oh, and if it seems like I foster pharmaceutical intervention, the above is a big problem in certain drug trials, especially antidepressants, but also in psychotherapy.

I have only one strong opinion on this area, and that is concerning the moralistic "I was slothfull, lazy and fat, now I accepted Kellogg as my saviour, so it's your sin also that you are so fat."-crowd. You only proved that there is a certain possibility[1] that it was YOUR sin that kept you fat, so could you please wear your simple, unadorned, worn rags["], shave your head and be quiet, as befits repenitent sinners? THNX

[1] As already pointed out, there is a certain possibility that it was a mere coincidence and not your lifestyle change; and then who's to say it was the exercise and not a sense of empowerment from thinking yourself in control of your body shape, switching some subtle endocrinological markers since the end of gloom means there is no need to salvage reserves for the next famine?
[2] Please no 'I'm more humble than thee!'

215:

Well, on a lighter note, let's keep to the Classics, it's likely because of the better water supply, just do some holidays in the Sahara; after all, Hippocrates can't be wrong, look at his data on the Scytians:

http://classics.mit.edu/Hippocrates/airwatpl.mb.txt

To justify this excursion, well, first of I'm of partly Eastern (or better, Eastern Middle) European extraction, and the description of the Scythians always keeps me giggling at the mirror, well, except for the hairy part, but not everyone can be a bear like me, grr.

And then, you really can't appreciate the odd quirks of this paper too much, the sketchy data base (if we're really lucky, he managed to get to some Greek colonies in the Krim), the connotation with current stereotypes (see 'phlegmatic slavs', 'Finno-Ugrian depression genes' and like), the total misunderstanding of foreign cultures, linking ornamental or ceremonial scarification and/or tattoos to drying the body, the questionable ecological knowledge about the Eurasian steppes, no big animals, err, even taking the Megafaunal extinctions into account, what about the wisent and saiga, and last not least the possible errors in ethnography and physical anthropology, given the likely heterogenity of the population, fleshy faces in Mongols and like don't necessarily mean obese.

http://asiasociety.org/files/mongoliamotherdaughter.jpg

And to justify this little excursion, well, who's to say any talk about 'mediterranean diet', Eastern Asian cuisine and like isn't flawed in the same way? *g*

216:

"Organic" farming - It shouldn't be about "nasty artificial agrochemicals". I defy anyone to tell the difference between soil ammonia from the Haber process and from manure, when testing for ammonia. What it should be about is "not stripping the soil back to sterile silica dust", and you just need to cut back fertiliser etc 10% from full on intensive agriculture and carry out crop rotation: IE basic soil husbandry, to make this work.

#194 - Fair enough; that's Qi detaction experimental design, and not questioning a statement of "I saw/felt something unusual and memorable in one individual, so I think there may be something in this".

217:


Gary Taube's book, mentioned up thread, is worth reading by those who are interested in this whole subject. It is not a diet book. It is a comprehensive survey of the last hundred and fifty years of diet research and concludes with an exhaustive bibliography.

Or particular relevance to the current debate are the studies in overfeeding. An example: "In 1999, James Levine from the Mayo Clinic reported that he had overfed sixteen healthy volunteers by a thousand calories a day, seven days a week, for eight weeks. The amount of fat these subjects managed to put on ranged from less than a single pound to almost nine; “fat gain varied ten-fold among our volunteers,” Levine reported."

If a calorie is a calorie is correct the volunteers should have gained 17 pounds. 56000/3300 = 16.96

218:

I feel rather insulted that you presumed my questions were not posed in order to enable a correct experimental design to test your hypothesis. All were about factors potentially affecting subliminal perception of the presence of an individual and would have to be taken into account. Some anecdotal evidence regarding those would be helpful to the experimental design and might avoid a lot of wasted time investigating the wrong thing.

The experiment as designed by Steve Simmons @194 assumes that the perception of qi is possible through a solid opaque screen, so would not be directly relevant to your reported experience. It could help to eliminate other factors such as smell, however.

The subject being told that it is a high-qi individual when it is actually a low-qi individual (and vice versa) behind the screen would be particularly interesting to me.

219:

Ok Pat, rightly or wrongly your questions were coming across as "I don't believe you" rather than "experimental design". I presume you can see why someone might feel that to be trolling?

I'm sure you'll agree that telling someone about "the day I was put out the karate dojo" is a strange conversation to have face to face with someone the first day you meet them, unless you're talking about karate generally? (I'm interested in the Orient generally, but not to the point where it's the first thing I'd say to someone unless I had a specific reason to do so, which I didn't.) I'd known the guy for several weeks by that time, and the point was that the tale was credible. Since 2 completely different people in 2 very different situations (building site office and karate dojo) noticed the same thing about this guy...

220:

Actually, no, I can't see it being misinterpreted as trolling as I was answering your question directly and simply. You asked:

"Any other factors you feel a need to consider?"

Was that a rhetorical question? Surely you weren't being sarcastic? Extraordinary claims require extraordinary examination.

221:

Ghrelin also has an effect on obesity. It's been found that obese people who can't lose weight produce more ghrelin. Like you I put on weight over a very short period of time - 30kg in three months - but even prior to that I'd been working out for 2.5 hours a day and eating very little just to control my weight, which implied that there was an issue with my body chemistry prior to the weight gain. Having the part of the stomach removed that stimulates ghrelin production caused dramatic weight loss and allowed me to eat normally, i.e. over 1000 calories a day without gaining weight. I'm living proof of this. And not only can I eat normally, but I can eat anything and still lose weight. My body is fixing itself back to a normal size regardless of what I eat or what exercise I do (though I do walk the dogs daily). I've lost 30kg in 7 months and have been eating all the things I'd never dream of eating prior to this, like chocolate, fries, bread products etc... It's amazing being a normal person. My surgeon said that if he could isolate the ghrelin issue without having to resort to surgery he'd probably win a nobel prize.

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This page contains a single entry by Charlie Stross published on November 24, 2010 5:37 PM.

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